NHS reforms

No summer respite for NHS as surgery waiting numbers highest in a decade

The number of patients waiting for planned surgery has now risen above four million for the first time since 2007, performance statistics have today shown.

In NHS England’s monthly update on performance for June and July 2017, the same trend of increasing demand highlighted in April’s figures was again outlined, as A&E attendances were up 1.3% and face-to-face ambulance responses also increased by 4.6% from the same period last year.

Figures also revealed that NHS constitution standards were not met for Category A ambulance responses in June, or for A&E waiting times in June or July.

Standards in A&E were also shown to be slipping again, as 90.3% of patients were admitted, transferred or discharged from A&E in July 2017 within four hours of arrival – below the standard of 95%.

For ambulance responses, standards were not met for all categories of call. For Red 1 and Red 2 calls, the response standard of ambulances arriving at the scene within 8 minutes for 75% of patients was missed, as the figures stood at 68.8% and 61.8% respectively.

Delayed transfers of care were also found to be on the rise, as there were 178,441 in June 2017 compared to 173,122 in June 2016.

Experts at the Nuffield Trust commented that today’s figures show that the NHS was not coping with huge demand under stretched budgets.

“These figures show that the NHS continues to be systematically unable to meet its main targets, with over 4 million patients likely to be on the waiting list for planned care – now at its longest since the end of 2007,” said John Appleby, director of research at the think tank.

“For the second year in a row, even the summer respite in A&E has not led to hospitals being able to meet their four-hour target, with just 90.3% of people being treated in four hours compared to the expected 95%.”

Appleby added that the rate of patients being held up leaving hospital was “troublingly high”, and was showing little sign of coming back under control, with delayed days at their highest ever level for the month of June.

“This puts the NHS on the back foot as we approach winter, with problems both at the ‘front door’ of A&E departments and at the ‘back door’, as hospitals struggle to send people home or onto further care.”

Providers: additional capacity must be put in place for winter

NHS Providers also commented saying that the figures made for yet more difficult reading. Head of analysis at the organisation Phillippa Hentsch explained: “These figures show even at the height of summer, the NHS is working at full stretch.

“Demand is continuing to grow. For example, the number of patients waiting for routine treatment, such as knee and hip operations, has now risen to four million.

“There is clearly an urgent need to put in place additional capacity to cope with the pressures of the coming winter.”

Hentsch added that the lack of progress in reducing delayed transfers of care (DToCs) for patients who are ready to move on is particularly worrying, as this leads to longer waits right across the system, including for those who need to be admitted.

“The increase in DToCs attributable to social care – especially those waiting for suitable support in their own home – must be addressed,” she argued.

“The lesson here is that there is simply not enough capacity in the system to assure patient safety in the coming winter,” the Providers lead concluded. “We need an immediate decision on whether trusts will be funded to cover the current capacity gap.

“We estimate that somewhere between £200 and £350m is required – that must be something we can find within an overall health budget of £124bn.”

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