Waiting times in A&E departments

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.

Full article: What’s going on with A&E waiting times?

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Latest Quarterly Monitoring Report finds Patient care deteriorating

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.

Full report: The Kings Fund Quarterly Monitoring Report November 2017

Six-month-plus surgery waits triple in four years

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)

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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.

More via OnMedica

Full detail: Consultant-led Referral to Treatment Waiting Times

 

A guide to managing efficient elective care

Guidance for NHS staff involved the delivery of acute elective care who want to understand how best to manage and deliver referral to treatment (RTT) pathways and standards | NHS Improvement

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Image source: NHS Improvement

Our guide covers those areas which support the operational delivery of an effective RTT pathway, including demand and capacity planning, elective access policies, performance management and reporting.

It gives advice on the management of the RTT pathway, derived from what we’ve learned from helping NHS organisations across the country to deliver and sustain short waiting times for treatment

Also included are:

Read the full overview here

The core guidance is available here

A&E under pressure

The number of patients waiting four or more hours at A&E has risen more than 300% at some hospitals |  BBC News

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In total, 2.2 million patients were not seen within the target time in 2015-16 – more than double the one million figure in 2013-2014.

The Royal College for Emergency Medicine (RCEM) says there is a “large and systemic problem” caused by a lack of hospital beds.

NHS England said hospitals were under pressure but continuing to cope. Across England in 2015-2016, 85% of patients were seen within four hours.

Full story via BBC News

NHS Indicators: England, January 2017

The House of Commons library has published NHS Indicators: England, January 2017.

The full briefing paper looks at trends in the following areas:

  • Accident & Emergency attendance and performance
  • Ambulance demand and response times
  • Waiting times and waiting lists for routine treatment
  • Waiting times for cancer diagnosis and treatment
  • Cancelled operations
  • Delayed discharges and transfers of care
  • Diagnostic waiting times and activity
  • Waiting times for mental health treatment
  • Workforce numbers for doctors, nurses and other staff
  • Hospital activity, referrals and admissions
  • Bed availability and occupancy

Access the full report here

Care quality measures

The Health Foundation and Nuffield Trust have published Quality at a cost: QualityWatch annual statement 2016.

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.

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Image source: http://www.qualitywatch.org.uk/

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:

  • Public health
  • Primary care
  • Ambulances
  • Hospital care
  • Mental health
  • 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.