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NHS missing targets in emergency and elective care

Latest statistics reveal a service under strain

Jo Carlowe

Thursday, 09 June 2016

The NHS performance statistics published this week, reveal missed targets for both emergency and elective care.

The data, for April 2016, also shows a long-term trend of greater volumes of both urgent and emergency care. 

Emergency admissions are up by 3%, diagnostic tests by 6.4% and A&E attendance by 2.3%.

The statistics reveal that in the case of urgent and emergency care in April, the NHS constitution standards were not met for A&E waiting times or ambulance standards. 

Of A&E attendances, 90% of patients were admitted, transferred or discharged from A&E within four hours of arrival, below the 95% standard. 

In the case of elective care, the standards were met for six of the eight cancer standards, but not for referral to consultant-led treatment within 18 weeks, diagnostic tests, two week wait referrals for patients with breast symptoms, or 62-day wait for urgent GP referral to treatment for cancer. 

With regards to ambulance response times, 71.3% of red 1 calls were responded to within 8 minutes — the eleventh month in a row in which the standard of 75% has not been met.

Some 1.8% of patients waiting at the end of the month for diagnostic tests had waited six weeks or longer from referral for one of the 15 key diagnostic tests, higher than the standard of 1%.

The data also revealed delayed transfers of care. In April 2016, there were 167,677 delayed days, compared to 138,030 in April 2015. There were 5,924 patients delayed at midnight on the last Thursday of April 2016 — the highest number since monthly data was first collected in August 2010. 

Pressure on NHS 111 also increased, with calls up by 5.4% compared to April 2015. The proportion of calls abandoned after waiting longer than 30 seconds was 2.8%, a large drop on the 8.4% recorded in March. 

Matthew Swindells, NHS England’s National Director of Commissioning Operations and Information, said the figures reflected social care-related delays and pointed to a number of areas where figures had improved. 

“April’s figures show frontline services beginning to recover from a challenging winter and a late spike in flu, with A&E performance nearly 3% higher this month. The number of patients waiting more than four hours fell by over 50,000, and more than nine out of ten patients are now being admitted, treated or discharged within the target time.

“However, these new figures also show social care-related delayed hospital discharges up by 37% compared with last year – further proof that increasing pressures in social care are spilling over into the NHS. Services were also affected in April by two 48-hour periods of industrial action.”

Commenting on the monthly NHS performance figures published by NHS England, Stephen Dalton, Interim Chief Executive, NHS Confederation, said: “The NHS is straining to deliver a high standard of care in the face of huge financial and demand pressures. 

“These performance figures should be a trigger to accelerate efforts to transform care, rather than to heap more pressure on the NHS as a whole. Improving care and the performance of our NHS will only be delivered through local and inclusive health and care partnerships, including with the communities we serve.

“This is an urgent call to Government to quicken the pace and enable NHS and Local Authority leaders to work together to transform health and care services. The needs of people have changed and demand continues to outstrip resource. Unless we break the cycle, we will continue to see performance results that expose the problem, not offer any solutions.”

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