Health

NHS winter crisis: Worst EVER delays in A&E


NHS hospitals are performing worse than ever before and are ‘stretched to breaking point’, a raft of damning statistics have today revealed.

Just 81 per cent of A&E patients were treated within the target four hours in November, with nearly 360,000 waiting longer and 1,112 facing delays of 12 hours or more. 

Hospital beds are so full – only five out of every 100 are free overnight – that doctors and nurses just don’t have any space to admit new patients.

Meanwhile, a record number of people were rushed to hospital in an ambulance in November (743,824), with almost 25,000 turning up every day.

And around 4.45million patients had faced waits of more than 18 weeks to undergo routine operations such as hip replacements in October.

In another worst-ever performance, figures show the number of cancer patients who started treatment within two months was just 83 per cent in October. 

Health experts said today’s bombshell is an immediate reminder for returning Prime Minister Boris Johnson of the ‘grim’ situation the NHS finds itself in.

The state of the NHS had been thrust front and centre of the election campaign, with all eyes now on the victorious Conservatives to try and get the NHS back on its feet.

The number of patients being treated at A&E within the NHS's target four hours has plummeted over the past nine years and now almost one in five people (19 per cent) end up waiting longer, statistics have revealed

The number of patients being treated at A&E within the NHS’s target four hours has plummeted over the past nine years and now almost one in five people (19 per cent) end up waiting longer, statistics have revealed

Separate figures released by health chiefs this morning show norovirus and flu are crippling the overwhelmed health service.

Twice the number of hospital beds were closed from the winter vomiting bug last week, compared to the same time point last year. 

And bed occupancy rates were almost 95 per cent last week, well above the limit deemed safe by the NHS. One trust even reported having no free beds. 

Doctors have repeatedly warned the country’s emergency care is ‘imploding’ and that no political parties have credible plans to rescue it.

Experts said today's NHS figures are an 'immediate reminder' for Prime Minister Boris Johnson who, after winning a landslide election last night, will be tasked with helping to get an ailing health service back on its feet

Experts said today’s NHS figures are an ‘immediate reminder’ for Prime Minister Boris Johnson who, after winning a landslide election last night, will be tasked with helping to get an ailing health service back on its feet

NEW GOVERNMENT FACES PRESSURE TO FIX NHS ‘ON ITS KNEES’ 

Boris Johnson’s Conservative Party will face pressure from throughout the health service to try and get hospitals out of what appears to be year-round crisis.

The state of the NHS was thrust to centre stage of the election campaign this week when photos emerged of two children asleep while waiting for hospital beds – one on the floor and another on a chair.

Nine-month-old Lily was pictured sleeping on a chair at 2am at a hospital in Merseyside because no hospital beds were free

Nine-month-old Lily was pictured sleeping on a chair at 2am at a hospital in Merseyside because no hospital beds were free

The Conservatives have promised a £33.9billion funding boost for the NHS, 50,000 more nurses, 50million more GP appointments each year, 6,000 more GPs, 40 new hospitals and 20 upgraded ones.

The Royal College of Nursing’s Dame Donna Kinnair said: ‘The Prime Minister must remember that the Government’s new mandate was secured on the back of health and care pledges over which we will hold them to account.

‘Nursing cannot afford any more piecemeal workforce planning, nor underfunding and working conditions that both put off new recruits and cause experienced nurses to leave the profession they love.  

‘Any attempts to row back from what patients need will be met with short shrift from the nurses who serve them. 

‘Extensive expert research shows that registered nurses are the key to patient safety, and it needs to be clear in law who in Government and in the system is responsible for ensuring there are sufficient numbers of nurses to meet patients’ needs.’  

Richard Murray, chief executive of healthcare think-tank The King’s Fund said: ‘These sobering figures show the urgent need for the new Conservative government to make good on its promises to focus on our ailing health and care services.’

Matt Hancock, the Government's Health Secretary, has spearheaded promises to invest billions of pounds in new and upgraded hospitals and to recruit more nurses and doctors (Pictured: Mr Hancock visiting the Countess of Chester Hospital)

Matt Hancock, the Government’s Health Secretary, has spearheaded promises to invest billions of pounds in new and upgraded hospitals and to recruit more nurses and doctors (Pictured: Mr Hancock visiting the Countess of Chester Hospital)

And the Nuffield Trust’s Nigel Edwards added: ‘The new Government really will need to deliver the 50,000 nurses promised – even if this means more reliance on migrants than they’ve said. 

‘We need a long-term commitment to funding for NHS infrastructure, not one-off announcements. And we need to finally see the overhaul of England’s failing social care system that has been pledged so many times.’ 

The British Medical Associaton’s Dr Chaand Nagpaul said: ‘It’s vital that the Government starts today to make a difference on the frontline – especially as we head into the busiest time of the year. 

‘The challenges are huge, which is why the BMA calls upon the Government to act immediately to halt the decline in our NHS.’

The Royal Bolton Hospital in Greater Manchester (pictured) was this week put on 'black alert' after its A&E department was overwhelmed by patients and at least 15 trusts have put out messages urging people not to go to A&E except in a life-or-death situation

The Royal Bolton Hospital in Greater Manchester (pictured) was this week put on ‘black alert’ after its A&E department was overwhelmed by patients and at least 15 trusts have put out messages urging people not to go to A&E except in a life-or-death situation

The shocking figures come as hospitals across the country have urged patients to stay away from crowded A&E units.

At least 15 trusts have appealed to the public to only attend with genuine medical emergencies via Twitter or their own websites.

They include the Royal Bolton Hospital in Greater Manchester which issued a ‘black alert’ last week, the highest level of escalation.

Senior doctors say A&E units are more overcrowded than usual for this time of year, a problem compounded by flu and norovirus, which have both arrived early.

Hospitals are struggling to keep pace with demand and seriously ill patients are coming in at a much faster rate than they are being discharged.

A&E units are rapidly becoming overcrowded as patients have to be kept on trolleys in corridors as they wait for a free bed on a ward. 

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, which represents A&E doctors, said: ‘Performance continues to plummet to record lows despite the best efforts of staff.

A&E department performance has dropped dramatically even over the past year, falling from more than 86 per cent of patients being seen within four hours of arriving, to fewer than 82 per cent

A&E department performance has dropped dramatically even over the past year, falling from more than 86 per cent of patients being seen within four hours of arriving, to fewer than 82 per cent

‘Our hospitals are near full and the number of patients needing to be admitted to a bed continues to rise year on year.

‘Thousands of patients are staying longer than 12 hours in emergency departments each week.

‘Patients are suffering as a result of years of under-resourcing. We welcome the promises made on health spending by the new government.’ 

In November 358,131 A&E waits lasted longer than four hours before the patient was admitted, treated or sent home, and 1,112 of those who were admitted onto a ward waited longer than 12 hours to get there.

A separate figure showed 18.6 per cent of the total 2,143,336 attendances lasted four hours or more – a record high.

And, for the first time, not a single major A&E unit in England (118) managed the target of processing 95 per cent of its patients within four hours. 

October’s A&E statistics were the worst ever when they came out – with 83.6 per cent of patients waiting longer than four hours – and November’s have dropped even lower, to 81.4 per cent.

WARDS ARE TOO FULL FOR NEW PATIENTS 

Only five out of every 100 beds in England’s hospitals were available for new patients last week, NHS statistics show.

Overnight occupancy rates hit an average of 94.9 per cent in between December 2 and December 8.

The amount of free beds varied around the country, and 15 hospital trusts didn’t have a single free bed on at least one night last week.

One – North Middlesex University Hospital in London – was 100 per cent full all week, with its only lull from maximum capacity a small drop to 99.7 per cent on Wednesday, December 4.

The hospital recently said the figures are inaccurate because it has back-up beds which aren’t recorded.

Chief executive of the Nuffield Trust healthcare think-tank, Nigel Edwards, said: ‘Bed occupancy at 95 per cent [is] a level which will make it near impossible to admit many patients in need onto the right ward.’  

A total of 86 hospital trusts out of 132 recorded had occupancy rates of 95 per cent or higher. 

Chief executive of the Nuffield Trust healthcare think-tank, Nigel Edwards, said: ‘Returning to Downing Street, Boris Johnson has been met by an immediate reminder of the grim winter his Government faces in the English NHS.

‘The November figures show the number of patients waiting on trolleys is at its highest level ever, a very worrying sign with the coldest months still to come. 

‘For the first time, not one single major A&E department in England met the current four hour waiting time target. 

‘Figures for the first week of December suggest what may be driving this, showing bed occupancy at 95 per cent, a level which will make it near impossible to admit many patients in need onto the right ward.’

Experts are unanimously calling for more money to be invested in boosting staff numbers and modernising outdated facilities.

Just 81 per cent of A&E patients were treated in A&E in four hours in November - and 1,112 of them faced delays of 12 hours (stock image)

Just 81 per cent of A&E patients were treated in A&E in four hours in November – and 1,112 of them faced delays of 12 hours (stock image)

Even seriously-ill cancer patients are being hit by staff shortages as more and more of them are having to wait eight weeks or more to start treatment after being referred by a doctor

Even seriously-ill cancer patients are being hit by staff shortages as more and more of them are having to wait eight weeks or more to start treatment after being referred by a doctor

NOROVIRUS VOMITING BUG SHUTS THOUSANDS OF BEDS

More than 7,000 hospital beds had to be closed off last week because of the winter vomiting bug spreading, NHS data has revealed.

Some 1,200 were empty but out of bounds for new patients because there were highly contagious patients nearby.

Norovirus, along with flu, is a big contributor to soaring pressure on the NHS in the winter because it can cause diarrhoea, vomiting and dehydration and spreads rapidly.

Public Health England said today levels of norovirus are the highest they’ve been in the past three years.  

Figures for the last week of November showed 465 reported cases of the bug, which is 48 per cent higher than usual for that time of year (average 314). 

PHE’s Nick Phin said: ‘Norovirus activity continues to increase and cases of norovirus are at levels higher than we would usually expect to see at this time of year. 

‘We advise people with symptoms not to visit GP surgeries and hospitals, however if they are concerned they should contact NHS 111 or talk to their GP by phone.’  

They said it was vital that the new Conservative Government made good on its promises of new buildings, equipment and staff.

Richard Murrary, chief executive of health think-tank The King’s Fund, added: ‘Hospitals are constantly operating in the red zone, with NHS trusts struggling to cope with more than 100,000 vacancies.

‘Winter has only just begun, and the NHS is already stretched to breaking point.

‘Increasing levels of flu and chronic staff shortages exacerbated by the ongoing pension crisis point to a torrid few months for the health service.’

Staff within the NHS itself have warned it’s ‘on its knees’ and worse is yet to come.

Niall Dickson is the chief executive of NHS Confederation, which speaks on behalf of hospitals, ambulance trusts and local health boards.

He said: ‘These figures show an NHS on its knees and it is no wonder that most leaders predict that this winter will be the worst on record. 

‘More and more patients are turning up at emergency departments and there is a limit as to how many they can cope with. 

‘Frontline staff are working themselves into the ground but with the current level of vacancies, and ever rising demand, there is only so much they can do. 

‘We need our newly elected Government to get to work now with new services in the community that will relieve the pressure on hospitals, as well as action on staffing, social care, and capital investment.’

Political pressure will now be aimed squarely at Boris Johnson and his re-elected Conservative Party to fix the crumbling NHS.

The party has promised a £33.9billion funding boost for the NHS, 50,000 more nurses, 50million more GP appointments each year, 6,000 more GPs, 40 new hospitals and 20 upgraded ones.

The Prime Minister, pictured at King's Mill Hospital in Mansfield in November, is leading a Government which has promised huge investments in the NHS and thousands more doctors and nurses

The Prime Minister, pictured at King’s Mill Hospital in Mansfield in November, is leading a Government which has promised huge investments in the NHS and thousands more doctors and nurses

WAITING LIST HITS ANOTHER RECORD HIGH 

The number of people waiting to have routine surgery was another measure on which the NHS today revealed it has hit a record high.

Data for October, released today, showed 4.45million people are waiting for planned operations such as hip or knee replacements or cataract surgery.

The figure was a rise from 4.42million in September and it has been increasing steadily for almost the entire year – it was just 4.17m in January, which was then the second longest list on record.

In his victory speech this morning, Mr Johnson said to supporters in London: ‘This one nation Conservative government will massively increase our investment in the NHS, the health service that represents the very best of our country with this single beautiful idea that whoever we are – rich, poor, young, old – the NHS is there for us when we are sick and everyday that service performs miracles.

‘That is why the NHS is this one nation conservative government’s top priority and so we will deliver 50,000 more nurses and 50million more GP surgery appointments and how many new hospitals? [crowd replies ‘forty’].

‘Correct. And we will deliver a long term NHS budget enshrined in law, £650 million more every week and all the other priorities that you the people of this country voted for.’

In a tweet this morning, Labour’s Shadow Health Secretary, Jonathan Ashworth, said: ‘Yesterday the Tories won five more years with a massive majority. 

‘Today we learn A&E waits fallen to worst ever level. It’s makes our failure all the more heart breaking. 

‘Tories made big pledges on NHS – we’ll soon see whether patients start receiving the improvements promised.’

Health leaders said the time could not come soon enough for Mr Johnson and the Conservatives to turn their promises into action.

The Royal College of Nursing’s Dame Donna Kinnair said: ‘The Prime Minister must remember that the Government’s new mandate was secured on the back of health and care pledges over which we will hold them to account.

‘Nursing cannot afford any more piecemeal workforce planning, nor underfunding and working conditions that both put off new recruits and cause experienced nurses to leave the profession they love.  

‘Any attempts to row back from what patients need will be met with short shrift from the nurses who serve them.’ 

This winter the usual pressures are being exacerbated by the winter vomiting bug norovirus, as staff have to close off precious beds to contain the infection. 

An NHS England spokesperson said: ‘These figures show that NHS teams across the country are providing a record-breaking level of care to the increasing numbers of people, at a time when norovirus and flu is having a greater impact on local services than last year.’ 

Crisis figures were expected to have bolstered voting numbers for Jeremy Corbyn and his Labour Party (pictured on the campaign trail with nurses and Shadow Health Secretary Jonathan Ashworth at Crawley Hospital), who have for years pointed the finger at the Conservatives for underfunding the NHS

Crisis figures were expected to have bolstered voting numbers for Jeremy Corbyn and his Labour Party (pictured on the campaign trail with nurses and Shadow Health Secretary Jonathan Ashworth at Crawley Hospital), who have for years pointed the finger at the Conservatives for underfunding the NHS

CANCER TREATMENT WAITING TIMES ARE LONGER THAN EVER

NHS patients outside of emergency departments are feeling the impact of staff shortages and immense pressures, too.

For cancer patients, waiting times have become longer than ever and just 83 per cent of patients now start treatment within two months of being referred to a specialist by their doctor.

The last 12 months has seen the lowest proportion of patients seen or treated within target time frames across all measures for all types of cancer.

It means around 19,000 people with suspected cancer have waited two weeks or more to see a consultant about their illness. This was 91.4 per cent of the total patients – the NHS target is 93 per cent. 

And a survey by Macmillan Cancer Support found that one in five people recently diagnosed with or treated for cancer said the nurses and doctors looking after them appeared to have ‘unmanageable’ amounts of work to do.

Daloni Carlisle, from Kent, was diagnosed with womb cancer in 2014 – her disease can be treated to keep it under control but never cured

Daloni Carlisle, from Kent, was diagnosed with womb cancer in 2014 – her disease can be treated to keep it under control but never cured

Macmillan’s chief executive, Lynda Thomas, said: ‘Health and social care professionals are doing a brilliant job faced with overwhelming pressures, but the odds are stacked against them and patient care is being compromised as a result. 

‘There are now three million people living with cancer in the UK and, as today’s figures show, more patients than ever are facing a long and worrying wait for a diagnosis and treatment.’

Daloni Carlisle, 55, from Kent, has ongoing cancer treatment after being diagnosed with womb cancer in 2014 which is treatable but not curable. 

She said: ‘I’ve been through it all – chemotherapy, radiotherapy, a hysterectomy. So many hospital appointments, so many fantastic staff but also far too many times just hanging around, anxiously waiting for appointments for up to two hours.

‘It’s stressful and physically difficult when you’re living with the side effects of treatment and the disease itself. 

Ms Carlisle said: 'Sometimes I wonder how they keep smiling - and believe me, despite it all, they do'

Ms Carlisle said: ‘Sometimes I wonder how they keep smiling – and believe me, despite it all, they do’

‘It must be equally difficult for the staff who end up apologising to sometimes angry and frustrated patients for delays that aren’t their fault. 

‘How can they possibly give the service they want to in these circumstances?

‘Sometimes I wonder how they keep smiling – and believe me, despite it all, they do.’  

Norovirus – known as the winter vomiting bug – is a big contributor to winter pressures on A&E because it causes sudden, unpleasant illness and spreads rapidly.

More than 7,000 hospital beds had to be closed off last week because of the illness.

Some 1,200 were empty but out of bounds for new patients because there were highly contagious patients nearby. 

Public Health England said today levels of norovirus are the highest they’ve been in the past three years.  

Figures for the last week of November showed 465 reported cases of the bug, which is 48 per cent higher than usual for that time of year (average 314).

PHE’s Nick Phin said: ‘Norovirus activity continues to increase and cases of norovirus are at levels higher than we would usually expect to see at this time of year. 

‘We advise people with symptoms not to visit GP surgeries and hospitals, however if they are concerned they should contact NHS 111 or talk to their GP by phone.’  

358,000 A&E PATIENTS WAIT LONGER THAN FOUR HOURS 

In November 358,131 A&E waits lasted longer than four hours before the patient was admitted, treated or sent home, and 1,112 of those who were admitted onto a ward waited longer than 12 hours to get there.

A separate figure showed 18.6 per cent of the total 2,143,336 attendances lasted four hours or more – a record high.

October’s A&E statistics were the worst ever when they came out – with 83.6 per cent of patients waiting longer than four hours – and November’s have dropped even lower, to 81.4 per cent.

Health leaders say increasing numbers of people going to emergency departments with flu or norovirus are contributing to massive rises.

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, which represents A&E doctors, said: ‘Performance continues to plummet to record lows despite the best efforts of staff.

‘Our hospitals are near full and the number of patients needing to be admitted to a bed continues to rise year on year.

‘Thousands of patients are staying longer than 12 hours in emergency departments each week.

‘Patients are suffering as a result of years of under-resourcing. We welcome the promises made on health spending by the new government.

‘For the sake of our patients, these promises must be turned into actions, and now is the time to act.’  



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