A&E units miss four hour target for seeing patients

Posted 13/12/2013

New figures show that the NHS in England has missed its four-hour A&E waiting time for the first time this winter.

In the last week, 94.8% of patients were seen within four hours compared to 95.6% the week before. The target is 95%.

The figures cover all centres – major A&Es, smaller minor injury units and urgent care centres. Waiting times are worst in the major units where only 92.2% were seen within four hours. The figures show two thirds of the 144 trusts with major units are missing the target. It is the first time since April the target has been missed overall – although the major units have been below the 95% mark since July.

A spokesman said that it is not unusual for performance to drop in December. For the last three years individual weekly figures have fallen below 95% before Christmas. Last winter the NHS was consistently below the 95% figure overall from January to April. Hospitals are given a 5% leeway to allow doctors to prioritise the sickest patients.

This was always going to happen. Every winter the NHS will miss the A&E waiting time target from time to time. What is important is where the NHS goes from here. The government has thrown extra money at the system – about £400m in total – to try to stop a repeat of last year when the waiting time target was consistently missed after Christmas.There are a number of factors that are out of everyone’s hands, including the weather. But there is a worrying picture developing.

The number of patients that come to A&E and then are admitted into hospital – i.e. the most serious cases – are high. What is more, hospitals are finding it difficult to discharge its frailest patients. These people often need support once they leave and the numbers show there are increasing delays in arranging that. The extra money was meant to ease these two problems in particular, but there is little to suggest that has happened. The worry now is that hospitals get clogged up and pressures continue to build.

NHS England chief operating officer Dame Barbara Hakin said it was “disappointing” performance had dropped, but said last week was the busiest so far this winter with more than 415,000 people attending A&E, while the numbers that needing admitting to hospital for further treatment – emergency admissions – hit its highest level since 2010. She added: “We know the A&E standard is ambitious and that is only right. This is the first week since April the 95% standard has not been met, however we do know that sometimes this will happen. Every year we see a dip in the figures for December, with week on week variations which is why we fully assess how local systems are coping with winter pressures over a longer period. We knew this winter would be difficult but it is important to stress the NHS continues to deliver a good service. This is thanks to the hard work and dedication of our frontline staff.”Julie Crossley, a medical injury lawyer at Ashtons Legal, comments: “This is worrying as currently the weather has been mild and we have not had any periods with below freezing temperatures so it is probable that the worst is yet to come. If the A&E Departments are falling below target this is likely to get worse despite the additional funding.”