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‘Winter of discontent’ warnings over latest NHS performance figures

Key measures of NHS services in England have continued to decrease, prompting warnings that providers are increasingly struggling to deliver services.

The performance figures for July 2016 show that there were 2,075,939 attendances at A&E, 6.3% more than at the same point in 2015, and only 90.3% of patients were admitted, transferred or discharged within four hours. The target for this key performance measure is 95%, which the NHS has now not met in over a year. It is also a small decrease from last month, when it was at 90.5%.

Siva Anandaciva, head of analysis at NHS Providers, said: “We are becoming increasingly worried about this continuing deterioration in performance. The summer is usually a quieter time for the NHS but these figures show the strain is being felt by NHS trusts all year round.

“We are heading towards a winter of discontent, with this relentless cycle of record high A&E attendances, increasing emergency admissions and greater numbers of patients who cannot be discharged because the services they need in the community are not being properly resourced. This is really taking its toll on NHS services and health care staff.

“We need to be honest with the public about the consequences of the longest and deepest financial squeeze in NHS history. The NHS will be performing heroically well to just maintain existing standards of care in the next 12 months. The real fear is that we lose all the progress achieved in recent decades to improve both the quality of care and how long people have to wait for it.”

Nigel Edwards, chief executive of the Nuffield Trust, added: “Today’s statistics, covering July, show that the days of a traditional summer respite for the NHS are gone for good.”

In addition, there were 184,188 days of delayed transfers of care, compared to 147,376 in July 2015. At midnight on the Thursday 28 July alone, 6,364 patients were delayed. Both figures are at their highest since records began in July 2010.

Edwards called these figures “particularly worrying” and said that NHS England and the Department of Health should “look more rigorously” at how they are calculated, because they could “systematically understate the true scale of the problem”.

A recent report by the National Audit Office warned that official measures of delayed transfers for elderly patients are failing to capture the full scale of the problem.

Among other measures, the figures show that 67.6% of Red 1 Ambulance calls received a response within eight minutes, below a standard of 75%, which has not been met since May 2015.

For Red 2 calls, the figure was 60.3%, with the target going unmet since January 2014, and for Category A calls, 89.5% of calls received a response within 19 minutes against a 95% standard, which has not been met since May 2015.

The figures also show problems with the NHS 111 service, which received 1,238,972 calls, a 21.9% increase on the previous year. Of these, 88.1% were answered within 60 seconds, compared to 90.6% in June, and 2.5% of patients hung up after waiting longer than 30 seconds, a rise from 1.8%.

For elective care, 1.4% of patients waited six weeks or longer for a diagnostic test after referral, with the 1% target going unmet since November 2013, and 82.2% of patients began cancer treatment within 62 days of an urgent referral, against an 85% target.

Matthew Swindells, NHS England’s national director for operations and information, said: “As the NHS responds to ever increasing care needs, hospitals are continuing to look after more than nine out of ten A&E patients within four hours, and more than nine in 10 patients are waiting less than 18 weeks for their routine operations. While this is probably the best performance of any western nation, these figures underline the pressures facing the NHS, and the obvious risks to patient care posed by weeks of further drawn out industrial action."

NHS services in England are due to suffer unprecedented five-day junior doctors’ strikes this autumn, after the British Medical Association called off strikes for next week but announced that they are due to go ahead in October, November and December.

Speaking at the NHS Expo yesterday, Simon Stevens, the CEO of NHS England, said that “no good for patients” could come out of the strikes.

(Image c. Peter Byrne)

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