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| Patients suffering as direct result of NHS wait-time failures | Patients suffering as direct result of NHS wait-time failures |
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| Doctors speak out as figures show NHS England has recorded its worst ever performance | |
| Denis Campbell and | |
| Pamela Duncan | |
| Thu 8 Feb 2018 18.53 GMT | |
| Last modified on Fri 9 Feb 2018 00.45 GMT | |
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| Patients are suffering as a direct result of the NHS’s inability to meet key waiting-time targets, doctors have warned. | Patients are suffering as a direct result of the NHS’s inability to meet key waiting-time targets, doctors have warned. |
| Doctors’ leaders spoke out after figures showed that the NHS in England recorded its worst ever performance last month, including against the politically important four-hour A&E treatment target. | Doctors’ leaders spoke out after figures showed that the NHS in England recorded its worst ever performance last month, including against the politically important four-hour A&E treatment target. |
| Just 77.1% of patients who sought help at a hospital-based A&E unit were treated and admitted, discharged or transferred within four hours – a record low against the duty to deal with 95% of cases within that time. | Just 77.1% of patients who sought help at a hospital-based A&E unit were treated and admitted, discharged or transferred within four hours – a record low against the duty to deal with 95% of cases within that time. |
| It was lower than the 77.3% it managed the month before, which was then the worst performance since records began in 2010. | It was lower than the 77.3% it managed the month before, which was then the worst performance since records began in 2010. |
| NHS England’s latest statistics graphically illustrate how the health service struggled to cope in January as it came under unprecedented strain as a cold winter and the worst flu outbreak for eight years led to the most intense demand it has faced. | NHS England’s latest statistics graphically illustrate how the health service struggled to cope in January as it came under unprecedented strain as a cold winter and the worst flu outbreak for eight years led to the most intense demand it has faced. |
| “Today’s figures show another record low. Warnings and recommendations have gone unheeded and the results of this are clear to see and borne out by the data; patients are suffering,” said Dr Taj Hassan, the president of the Royal College of Emergency Medicine, which represents A&E doctors. | “Today’s figures show another record low. Warnings and recommendations have gone unheeded and the results of this are clear to see and borne out by the data; patients are suffering,” said Dr Taj Hassan, the president of the Royal College of Emergency Medicine, which represents A&E doctors. |
| The statistics will have proved grim reading for NHS England and Jeremy Hunt, the health and social care secretary, who has pledged to ensure that hospitals improve their performance against the four-hour target. They prompted fresh claims from medical groups and Labour that the service’s struggles were due to understaffing and the government’s failure to give it the money it needs to do its job properly. | The statistics will have proved grim reading for NHS England and Jeremy Hunt, the health and social care secretary, who has pledged to ensure that hospitals improve their performance against the four-hour target. They prompted fresh claims from medical groups and Labour that the service’s struggles were due to understaffing and the government’s failure to give it the money it needs to do its job properly. |
| The figures also revealed that 81,003 people spent at least four hours on a trolley as they waited to be admitted to a hospital bed, a record for a single month. | The figures also revealed that 81,003 people spent at least four hours on a trolley as they waited to be admitted to a hospital bed, a record for a single month. |
| Of those, a record 1,043 were on a trolley for more than 12 hours, despite NHS bosses telling hospitals that that should never happen. | Of those, a record 1,043 were on a trolley for more than 12 hours, despite NHS bosses telling hospitals that that should never happen. |
| Such patients could die, Hassan said, adding: “International studies have consistently shown an association between long waits in emergency departments and avoidable deaths. These figures again make clear that patient safety is at risk.” | Such patients could die, Hassan said, adding: “International studies have consistently shown an association between long waits in emergency departments and avoidable deaths. These figures again make clear that patient safety is at risk.” |
| Prof John Appleby, the chief economist at the Nuffield Trust health thinktank, said: “A year ago we warned that corridors had become the new emergency wards. It is deeply concerning that 12 months on the position has worsened, with many harrowing reports of patients being treated in busy corridors by stressed and overworked staff.” | Prof John Appleby, the chief economist at the Nuffield Trust health thinktank, said: “A year ago we warned that corridors had become the new emergency wards. It is deeply concerning that 12 months on the position has worsened, with many harrowing reports of patients being treated in busy corridors by stressed and overworked staff.” |
| Hassan and Dr Nick Scriven, the president of the Society for Acute Medicine, which represents hospital specialists in acute medicine, said the figures disproved repeated claims by Theresa May and Hunt that the NHS was the best prepared it had ever been this winter. | Hassan and Dr Nick Scriven, the president of the Society for Acute Medicine, which represents hospital specialists in acute medicine, said the figures disproved repeated claims by Theresa May and Hunt that the NHS was the best prepared it had ever been this winter. |
| A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of England’s 153 acute hospital trusts was 98% or more, with the fullest – Walsall healthcare trust – 99.9% occupied. | A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of England’s 153 acute hospital trusts was 98% or more, with the fullest – Walsall healthcare trust – 99.9% occupied. |
| NHS England admits that the service “has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es”. | NHS England admits that the service “has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es”. |
| Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. “We are seeing conditions that people have not experienced in their working lives,” says Dr Taj Hassan, the president of the Royal College of Emergency Medicine. | Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. “We are seeing conditions that people have not experienced in their working lives,” says Dr Taj Hassan, the president of the Royal College of Emergency Medicine. |
| The unprecedented nature of the measures that NHS bosses have told hospitals to take – including cancelling tens of thousands of operations and outpatient appointments until at least the end of January – underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries. | The unprecedented nature of the measures that NHS bosses have told hospitals to take – including cancelling tens of thousands of operations and outpatient appointments until at least the end of January – underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries. |
| Read a full Q&A on the NHS winter crisis | Read a full Q&A on the NHS winter crisis |
| “Patients are quite clearly being made to pay for inadequate resources and continued underfunding. The extra £350m allocated in the budget – just enough to run the NHS for one day – was too little, too late,” said Hassan. | “Patients are quite clearly being made to pay for inadequate resources and continued underfunding. The extra £350m allocated in the budget – just enough to run the NHS for one day – was too little, too late,” said Hassan. |
| The figures also revealed that: | The figures also revealed that: |
| • Hospitals admitted 525,897 patients in January as medical emergencies, the largest number ever in a month. | • Hospitals admitted 525,897 patients in January as medical emergencies, the largest number ever in a month. |
| • Patients are facing the longest delays since 2009 for non-urgent hospital treatment, such as surgery to remove cataracts or replace broken hips. The NHS is increasingly breaching its duty to treat 92% of such patients within 18 weeks. | • Patients are facing the longest delays since 2009 for non-urgent hospital treatment, such as surgery to remove cataracts or replace broken hips. The NHS is increasingly breaching its duty to treat 92% of such patients within 18 weeks. |
| • Hospitals have temporarily had to divert patients from an A&E to another emergency department 287 times this winter. The Worcestershire acute hospitals NHS trust did that 65 times – more than any other trust – though it redirected patients between the A&Es at the two hospitals it runs, in Worcester and Redditch. | • Hospitals have temporarily had to divert patients from an A&E to another emergency department 287 times this winter. The Worcestershire acute hospitals NHS trust did that 65 times – more than any other trust – though it redirected patients between the A&Es at the two hospitals it runs, in Worcester and Redditch. |
| • Since late November, 138,463 patients have had to wait at least 30 minutes in the back of an ambulance or a hospital corridor to be handed over to A&E staff, another event NHS chiefs said should never occur. | • Since late November, 138,463 patients have had to wait at least 30 minutes in the back of an ambulance or a hospital corridor to be handed over to A&E staff, another event NHS chiefs said should never occur. |
| • 95% of hospital beds were full last week, 10% higher than the 85% limit health experts agree is needed to maintain patient safety. | • 95% of hospital beds were full last week, 10% higher than the 85% limit health experts agree is needed to maintain patient safety. |
| More positively, the number of hospital beds taken up by “delayed transfer of care” patients, who are fit to leave but cannot safely be discharged, has fallen, after determined efforts by hospitals and councils to improve discharge arrangements, especially the provision of social care. | More positively, the number of hospital beds taken up by “delayed transfer of care” patients, who are fit to leave but cannot safely be discharged, has fallen, after determined efforts by hospitals and councils to improve discharge arrangements, especially the provision of social care. |
| NHS England stressed that its performance against the four-hour target was better once figures for walk-in centres and urgent care centres were included. By that measure, which it prefers, it treated 85.1% of patients. However, that was still the third-worst monthly figure on record. Two-thirds of people seek A&E care at a hospital and the other third at those settings. | NHS England stressed that its performance against the four-hour target was better once figures for walk-in centres and urgent care centres were included. By that measure, which it prefers, it treated 85.1% of patients. However, that was still the third-worst monthly figure on record. Two-thirds of people seek A&E care at a hospital and the other third at those settings. |
| The Department of Health and Social Care declined to comment on the figures. Instead it said: “The NHS remains extremely busy but, despite the pressure, almost 3,000 more people were treated within four hours every single day in January compared to the same time last year.” | The Department of Health and Social Care declined to comment on the figures. Instead it said: “The NHS remains extremely busy but, despite the pressure, almost 3,000 more people were treated within four hours every single day in January compared to the same time last year.” |
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