Waiting times in accident and emergency (A&E) departments are a key measure of how the NHS is performing. In recent years, patients have been waiting longer in A&E; this article from the Kings Fund explores the reasons behind this.
The article reports that not only are more people are attending A&E departments each year, but A&E waiting times have also increased substantially over recent years. The NHS has not met the standard at national level in any year since 2013/14, and the standard has been missed in every month since July 2015.
At the same time, longstanding staffing issues and continued reductions in the number of hospital beds have made it more difficult for A&E departments to admit patients.
Half of NHS trust finance directors think patient care in their area has got worse over the last year, while just six per cent said it has improved | The King’s Fund
Analysis for the Kings Fund latest Quarterly Monitoring Report suggests that the NHS is heading into winter on a knife edge with performance worse than at this time last year against a number of key indicators:
89.7 per cent of A&E patients were seen within four hours in September compared to 90.6 per cent of patients in September last year.
89.4 per cent of patients waiting for treatment in August had been waiting up to 18 weeks for treatment in August, compared to 90.9 per cent in August last year. This is missing the target of 92 per cent. There are now 4.1 million people waiting for treatment, the highest number since 2007.
Emergency admissions are three per cent higher in September compared to the same time last year.
The report also shows that NHS finances remain precarious. Less than half of NHS trusts (45 per cent) expect to meet their financial targets this year, while commissioners are being forced to make tough decisions to reduce spending such as making people wait longer for planned treatment.
Trust finance directors also report widespread problems attracting nursing staff. The main reasons for this are the shortage in staff being trained; morale and work-life balance; and pay restraint.
The number of patients waiting longer than six months for surgical treatment in England has almost tripled in the past four years, according to the Royal College of Surgeons (RCS)
The RCS has today released a new analysis of waiting times data showing that, in March 2017, the number of patients waiting more than 26 weeks for treatment was 126,188, while in March 2013 (the year when six-month waiters were at their lowest level), 45,054 patients were waiting more than six months.
The data analysed shows that patients awaiting some types of surgery were experiencing particularly strong rises in waits for six or more months between March 2013 and March 2017. These included:
ear, nose and throat – a 256% rise
urology – 199% rise
general surgery – 146% rise
oral surgery – 146% rise
brain and spinal surgery – 145% rise
In addition, the analysis showed that the number of patients waiting more than nine months (39 weeks) for treatment rose by 209% during the same period. This was a rise from 6,415 patients in March 2013 to 19,838 patients in March 2017.
This report looks at a range of care quality measures across the NHS in England. It highlights several areas of health care where standards have improved, but the authors point to slowing improvement in other areas, growing waiting times and continuing financial pressures.
QualityWatch routinely monitors over 300 indicators spread across all domains of quality. This report considers a selection of areas from within this set, covering different stages of a patient’s experience of the health service, to give a picture of quality in 2016.
It looks across six main areas:
Condition-specific care (stroke and hip fracture)
The report observes that the pressure of austerity did not impact on quality measures straight away, but took a few years to be felt. Authors conclude that further ‘delayed decline’ could occur in other aspects of care quality, such as effectiveness of treatment or patient safety, given the extent of the challenges faced and ongoing austerity in health and social care spending.