Patient safety

09.03.18

A&E four-hour breaches ‘highest on record’ as care continues to worsen

The number of A&E patients waiting for more than four hours after a decision to admit them to hospital has reached record high, figures from the King’s Fund have revealed.

The think tank’s March quarterly monitoring report shows that over 81,000 patients waited for more than four hours, and over 1,000 patients have faced waits of over 12 hours – both the highest on record.

Patients undergoing routine treatment are also waiting longer, with 12% of patients waiting more than 18 weeks from GP referral in December 2017 – the highest percentage since March 2009.

According to the organisation, the four-hour A&E target and the 18-week target for routine treatment look increasingly unachievable, and it argued that the way that current targets operate is leaving growing numbers of patients facing long waits for treatment.

It is calling on the NHS to ensure that those not treated within the time limits do not experience long delays before they receive treatment.

The Fund said that its regular survey of NHS finance directors highlights worsening finances among NHS trusts, as well as the increasing financial difficulties for local commissioners, with over a third expecting to overspend this year – the highest proportion since the survey began.

It argued that this suggests that the Department of Health and Social Care may struggle to stay within its spending limits, despite the additional NHS funding announced in the Budget.

The report found that almost two-thirds of finance directors felt that patient care has worsened in their local area in the past year, and more than half said that they expected their trust to end the financial year in deficit.

Yet demand for services continues to soar, with A&E admissions jumping by almost 7% in January 2018 compared to the previous year.

Richard Murray, director of policy at the King’s Fund, said: “Waiting time targets are failing some of the patients most in need of emergency care.

“Our latest quarterly monitoring report underlines the heroic efforts of NHS staff to keep care standards high in the face of unprecedented pressure on services.

“But the way waiting times are designed means that there is very little protection for people who can’t be treated within the initial time limit. With demand for services likely to remain high, it’s very unlikely that meeting these targets will become more achievable.

“The waiting time standards should not be abandoned but the NHS needs to ensure the way they are implemented does not leave patients who are not treated within the time limits facing long waits for treatment.”

Top image: Eunika Sopotnicka

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