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NHS waiting times hit five-year high, report shows

More funding needed to uphold quality of care

Jo Carlowe

Friday, 12 May 2017

Waiting times for many NHS urgent and emergency services in England hit a five-year high, experts have warned.

According to the Health Foundation, waiting times were at their worst in 2016/17 for the last five years. However, there was little evidence to suggest that quality of care was deteriorating for major killers such as heart attack, and stroke.

In its election briefing, Qualify of Care in the English NHS - in the balance, the Health Foundation highlights that national data on the quality of care received by NHS patients lags behind information on waiting times and it may be too early to tell whether the pressures on the NHS are affecting the quality of care delivered.

Despite the increase in waiting times, the NHS is treating more patients than ever before. The number of people being treated within waiting times targets has remained relatively stable over the last five years and the difficulty to meet the targets reflects continuing growth in demand and pressure on resources.

Tim Gardner, senior policy fellow at the Health Foundation, said: “More people waited longer to access important areas of NHS care in 2016/17 – for things like admission to hospital from A&E, non-urgent surgery and cancer treatment – than at any time in the last five years.

“However, at the same time, the NHS is treating more people than ever before, including more people within the target waiting times. Crucially, for big killers like stroke, heart attack and some cancers, the latest data shows that the quality of care being delivered by the NHS is holding. This may be because it is too early to tell whether the pressures on the NHS are affecting the quality of care delivered. Or it may be a reflection of the incredible hard work of NHS staff to ensure good quality of care is maintained despite tightening resources.”

However, the report noted that the NHS was lagging behind comparable countries for some illnesses, including breast cancer.

Tim Gardner said: “While there have been internationally recognised improvements in the quality of care for heart attack and stroke – for other illnesses, such as bowel and breast cancer, the NHS is still lagging behind comparable countries on patient outcomes.

“Maintaining, let alone improving, the quality of care provided is going to be very difficult in the current financial climate. Funding for the NHS in England will need to increase if these hard won gains to the quality of patient care are to be upheld and built upon in the future. Waiting time targets for A&E, cancer, and consultant-led treatment are a useful barometer of pressure on the NHS. But these data need to be published alongside more relevant and accessible data on how effective care is for patients.”

On access (waiting times) to services, the briefing incorporates NHS England data which shows that 2.5 million people had to wait longer than four hours to be seen. A total of 23.4 million people visited A&E in 2016/17, up from 21.7 million in 2012/13 (when 901,411 were not seen within four hours).

For cancer treatment, 26,113 waited longer than 62 days to start treatment after GP referral, compared to 14,936 in 2012/13. 

For ambulance care, on the target that 75% of ambulances reach patients where there is an immediate threat to life within eight minutes, in 2016/17 this was met between 63-69% of the time, meaning that 985,583 people with life-threatening conditions waited longer than eight minutes for an emergency response. This compares to 74-76% in 2012/13, when 557,989 people had to wait more than the standard.

On the quality of care received by patients for some significant and prevalent conditions, the Health Foundation’s briefing highlights that the NHS had made substantial improvement in delivering rapid diagnosis and specialist hospital care for people with stroke. For example, in 2016, 47% of stroke services in England, Wales and Northern Ireland were graded as ‘first class’ or ‘good or excellent in many respects’ in the Sentinel Stroke National Audit Programme, compared with 21% in 2014. However, many patients are not receiving the level of follow-up care they need afterwards.

For heart attack, around nine in every 10 patients in the UK received ‘gold standard’ hospital treatment in 2015, according to the Myocardial Ischaemia National Audit Project, up from only five in 10 a decade before, although progress has levelled off in recent years.

Marked improvements were also seen in the quality of care for bowel cancer.

Responding to the report, Dr Mark Porter, BMA council chair, said: “These figures add to the growing body of evidence showing an NHS at breaking point, struggling to cope with increasing demand and leaving patients facing unacceptable delays for treatment.

“Our hospitals and GP surgeries are full, social care is collapsing, NHS staff are working under impossible conditions, and patients are being let down.

“At such a critical time for our health service, politicians must not forget the NHS as Brexit takes centre stage in the general election.

“It is vital for the next government to ensure that NHS funding keeps pace with other European nations, that the NHS and EU doctors in the UK are protected from the impact of Brexit, that general practice is properly supported, that policies protect and enhance the public’s health, and that the pressures impacting the day-to-day delivery of high-quality, safe care are tackled.”

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