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A&E waiting times reach nine-year high

Almost 6% of patients waiting more than four hours in A&E

Adrian O'Dowd

Tuesday, 04 June 2013

Government targets to ensure most patients are seen within four hours in A&E departments have been missed for the first time in two years.

Health watchdog The King’s Fund published a report today, which confirms data showing that in 2012-13’s final quarter, 5.9% of patients waited four hours or longer in A&E – the highest level since 2004.

Across the quarter as a whole, the government’s target that no more than 5% of patients should wait longer than four hours was missed for the first time since the Prime Minister pledged to keep A&E waiting times low in June 2011.

How is the health and social care system performing? is the eighth of The King’s Fund’s regular quarterly monitoring reports.

It shows that 313,000 patients (5.9%) spent four hours or more in A&E during January to March, an increase of more than a third on the previous three months and nearly 40% on the same quarter in 2011-12.

The information comes from publicly available data, which showed that nearly 40% of trusts (98) reported breaches in the target – an increase of 50% on the previous quarter.

Data also showed the proportion of patients waiting longer than four hours before being admitted from A&E to hospital – so-called trolley waits – rose to almost 7%, which is also the highest level since 2004.

Growing pressures on hospitals was also reflected in a survey of 51 NHS finance directors carried out in April for the report.

Pessimistic comments from the directors indicated that although the NHS was ending 2012-13 in a healthy financial position, the outlook for the next two years was bleak, with most respondents (96%) saying there was a risk of the NHS failing to meet its target to deliver £20 billion in productivity improvements by 2015.

The King’s Fund said so far, a large proportion of savings in the NHS had been achieved from an ongoing pay freeze for staff, reductions in prices paid to hospitals and cuts in management costs, but such savings would become increasingly difficult to sustain.

The report does contain some good news, as other NHS performance measures are holding up well, such as waiting times for referral to treatment in hospital, the number of health care-acquired infections and delays in transferring patients out of hospital, which are all remaining stable.

John Appleby, chief economist at The King’s Fund, said: “Emergency care acts as a barometer for the NHS. The worryingly high number of patients waiting longer than four hours in the last quarter of 2012-13 is a clear warning sign that the health system is under severe strain.”

Responding to the report, BMA chair of council Dr Mark Porter said: “This is a complex problem, and there are a range of contributing factors, but the basic fact is that doctors are working flat out to cope with the rising demand for services. Unfortunately, the evidence suggests that the problem will get worse before it gets better.

“Clearly, what matters most is that doctors are able to treat every patient based on their clinical need – not on an arbitrary target – but this report provides more evidence that the NHS has not been spared the impact of cost-cutting.”

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