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Calls to revise NHS targets as A&E figures continue to decline

Patient levels in the NHS are at record highs as the number of A&E patients being seen within four hours continues to decline.

In March this year, hospitals continued their trend of having the lowest success rate for A&E treatment since records began, for the third month in a row.

The amount of patients being seen within four hours was 87.3%, well below the 95% standard and the 92.7% achieved in March 2015.

Chris Hopson, chief executive at NHS Providers, said the figures showed that it is time to revise performance targets for the NHS.

“Today’s figures are predictable and reveal a maxed out health service struggling under the weight of financial strain and increasing numbers of patients requiring treatment,” he said. “This deterioration will be difficult to reverse and is more the result of undeliverable demands being placed on NHS trusts and foundation trusts than their individual performance.

“Every trust is committed to providing the best possible care and driving improvements but we need much more honesty and realism about what level of performance trusts can deliver for patients against this backdrop. When we run the NHS at capacity levels that no other advanced health system would even contemplate, it’s not surprising that large increases in demand lead to missed performance targets.”

Problem ‘for the entire health and social care system’

The figures also show a growing demand for NHS emergency services. The total number of attendances at A&E was 2,089,000, a 7.5% increase in a year, and the number of emergency admissions was 494,000, an increase of 4%.

However, Hopson said that as well as increasing patient numbers, the failure to meet targets was also due to problems with social services and funding, with many patients being left filling beds after they were ready to leave because there was nowhere for them to go.

He added that this was “a problem that must be resolved by the entire health and social care system, not just NHS trusts and foundation trusts.”

This month the NHS published its savings plan for the next five years, during which it is expected to save £22bn with efficiency savings targets of 2% or 3% every year.

Over the whole of the 2015-16 financial year, 91.9% of patients were seen within four hours, compared to 93.6% the previous year.

In the past month, just six out of the 138 trusts which submitted data achieved the 95% standard in all departments.

The data also showed that the highest performing trust was Luton and Dunstable University Hospital, where 97.5% of A&E patients were seen within four hours, and the lowest performing was North Middlesex University, with just 68.4%.

Emergency medicine a ‘Cinderella specialty’

Dr Cliff Mann, president of the Royal College of Emergency Medicine (RCEM), said that action must be taken to avoid even worse figures next month.

For too long emergency medicine has been treated as a Cinderella specialty. Unfortunately Cinderella is not going to the ball, she is resigning and seeking work elsewhere. Unless there is immediate action to address the epidemic of rota gaps patient care will be compromised and the current situation will deteriorate further.”

In a statement, the RCEM said that the figures showed that the much-criticised NHS 111 helpline is not working as intended to relieve pressure on A&E as many patients will refer themselves to emergency rooms after using the service.

The RCEM has launched a campaign, ‘STEP’, calling for action to address the challenges facing emergency medicine.

In a statement, NHS England said the figures showed the after-effects of the recent junior doctors strikes.

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