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NHS figures paint ‘bleak picture’ for staff and patients

Report shows NHS is 'stretching every sinew to meet rising demand' without the resources to do so

Louise Prime

Friday, 14 September 2018

The latest official NHS performance figures paint a bleak picture of what both staff and patients in Accident and Emergency (A&E) departments across the country have to endure on a daily basis, and demonstrate the need for assertive, joined-up action from government and policy makers, doctors’ leaders warned this morning. The NHS Confederation said the new data reveal not failure of the NHS, but “a service that is stretching every sinew to meet rising demand” without the means to do so.

A&E department attendances have soared by 22% in 10 years and more patients than ever before are spending 12 hours in emergency departments, according to the latest official statistics* from NHS Digital. Dr Rob Harwood, British Medical Association (BMA) consultants committee chair, warned: “This is an unacceptable amount of time for patients with urgent health needs, and for whom any wait can be both physically painful and distressing.”

NHS Digital’s report reveals that:

  • In 2017-18 there were 23.8 million attendances in A&E, an increase of 2% compared with 2016-17 and 22% since 2008-09.
  • For 2017-18, 88% of patient attendances spent four hours or less in A&E.
  • There were more than twice as many A&E attendances (3.0 million attendances) for the 10% of the population living in the most deprived areas compared with those living in the least deprived 10% (1.4 million)
  • England had the second-highest reported A&E attendance rate among the home nations, with 27,639 attendances per 100,000 population. Northern Ireland had the highest, with 34,820 attendances per 100,000 population (for type 1/major A&E departments).
In response to the figures, NHS Confederation chief executive Niall Dickson insisted: “This may look like an NHS that is failing – one target after another not being met. In reality it is anything but – this is a service that is stretching every sinew to meet rising demand, but it simply does not have the means to do so.

“And behind the cold impersonal figures are real patients with real stories and staff, too many of whom are under incredible strain. Targets such as a limit of four hours to wait in A&E, how long it takes to see a specialist doctor, the number of patients unable to get out of hospital – all these can spell individual patient misery and overstretched staff.”

He warned: “We cannot go on as we are. It will take time but we have to change the model, to support patients in their communities with hospital becoming the last not first resort. England is about to have a long-term plan – it is a chance to roll out a different approach but it will need radical thinking and more investment in GP, community health and social services.

“Every day, NHS staff across the country are doing their very best – but there are more than 100,000 vacancies – they cannot work miracles.

“The truth is the NHS has not met key performance targets since 2015, whether it is winter, spring, summer, or autumn. As winter looms, the NHS and our social care colleagues will do everything to prevent another season of misery, but they will need more support from the centre.”

The BMA said extra capacity must be built into the system, by investing in staff, resources and services, to avoid its own projections of a year-long crisis becoming the new normal. Dr Rob Harwood warned: “As summer draws to a close, winter will present its usual problems for A&Es, with further pressure leading to even longer waits, cancelled operations and a shortage of beds… without assertive, joined-up action from government and policy makers, both staff and patients will continue to bear the brunt.”

*Hospital Accident and Emergency Activity, 2017-18. Figures prepared by NHS Digital, 13 September 2018.

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