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Performance figures ‘worst we’ve ever seen'

NHS in ‘crisis’ despite mildest winter

Jo Carlowe

Friday, 15 March 2019

The latest NHS performance figures have been dubbed ‘the worst ever’ prompting experts to warn that the NHS is in ‘crisis’.

The monthly operational statistics revealed growing demand and missed targets. For example, nearly one in four cancer patients are waiting longer than they should for treatment to start — the worst performance since records began, in 2009.


And the attendance and emergency admissions figures for February 2019 reveal that only 75.7% of patients were seen within the four-hour target in type 1 A&E departments, which is the lowest since this collection began.

Commenting, president of the Royal College of Emergency Medicine, Dr Taj Hassan said: “Both these figures and the fact that this crisis is going unnoticed while the country is consumed by Brexit is deeply disappointing.

“These are the worst performance figures we’ve ever seen and come in the mildest winter for some time. With a long-term plan settled and focused mainly on redirection, there a few easy fixes for our Emergency Departments (EDs). Staff continue to work doggedly in difficult conditions and must continue to focus on patient safety.

“We absolutely must not lose sight of the people behind these numbers; both patients experiencing undignified conditions, and staff working at the limits of their abilities.”

Dr Hassan added: “The NHS must focus on filling the 100,000 staff vacancies it currently has, to relieve pressure on staff and ensure those patients most in need are seen, treated and discharged as quickly as possible. More staff – and beds – in other parts of the hospital will help to unclog the system and get things moving again in the ED. We would also urge the government to make the social care green paper a priority.

“We fear that these figures will give impetus to move away from meaningful measurement of flow and system performance, which if not managed carefully runs the risk of hiding problems. We look forward to working with NHS England on their new standards of measuring quality to ensure that this does not happen, and that patient safety and care continue to be paramount.”

The British Medical Association (BMA) also pointed to poor figures during what has been a mild winter.

Dr Simon Walsh, BMA emergency medicine lead, consultant committee said: “Despite a relatively mild winter so far, the fact that nearly two million patients attended an Emergency Department in February – a hundred and thirty thousand more than a year ago – shows that demand is relentless and that the NHS is truly in crisis. Doctors and nursing staff are struggling to cope each day and the news that, for the second month in a row, the four-hour target is at an historic low, while the number of patients having to wait four or more hours on hospital trolleys – almost 72,000, is also stark evidence of an NHS in ever-deepening decline.

“Patients being referred for planned or elective treatment are now having to wait two months, which often leads to a worsening of their condition. This is in turn adding to the workload of those who will care for them and often to a longer stay in hospital.

“It’s difficult to imagine the NHS in a much worse state, let alone the stress and appalling toll being taken on the health and wellbeing of both patients and doctors. It is hard to see how some of the ambitions contained in the government’s Long-Term Plan for the NHS can be realised unless the crisis in the NHS is addressed immediately and decisively. Patients and hard-pressed hospital doctors deserve so much better before lives are put at even more risk.”

And Patricia Marquis, Royal College of Nursing acting director for England, pointed to staffing problems. She said: “The A&E four-hour target hit its worst ever level last month, as did more than half the cancer targets. These bald statistics represent high levels of stress and anxiety for large numbers of patients – last month over 15,000 patients with suspected cancer couldn’t be seen by a specialist within the two-week target, while over 300,000 had to wait more than four hours in A&E.  It’s hard for nurses to reassure patients about the delays they’ve suffered in these circumstances.

“In addition, it’s shocking that more than 500 patients had to wait more than 12 hours on trolleys for a hospital bed last month after going to A&E, 41% more than this time last year. Patients who have to be admitted as emergencies from A&E are the very sickest, with many frail and elderly – nursing staff find it very distressing to have to try to care for patients in these circumstances.

“What’s worrying about all of today’s figures is that they come at a point when we haven’t yet had severe weather in England, and flu and norovirus levels are low. The failure to meet so many of the targets shows that NHS England is right to be piloting new approaches – but the fundamental reason the standards aren’t being met is huge shortages of staff.”

Responding, an NHS spokesman said: “NHS staff across the country have been working incredibly hard throughout winter to provide the best care for patients.

“Despite significant increases in demand, almost a quarter of a million more people have been seen and treated within four hours in A&E this winter compared to last year. Ambulance services are responding to life threatening calls faster, with fewer ambulance handover delays at A&E, and significantly more people have got the support they needed to avoid a long stay in hospital. Meanwhile tens of thousands more people are benefiting from timely tests or treatment, including for cancer and mental health.”

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