In the seven days to 7 December, 286,429 patients sought treatment from NHS A&E departments across England. Photograph: Robert Stainforth/Alamy
Figures revealing record numbers of patients waiting more than four hours for A&E treatment show that the NHS is “cracking under extreme pressure” and people are suffering, the leader of Britain’s doctors has said.
Dr Mark Porter, chair of council at the British Medical Association, also said growing numbers of sick people were facing “unacceptable delays” in receiving treatment and that the NHS couldn’t cope with the sheer number of patients needing help from hospitals, GP surgeries and ambulance services.
Porter was responding to a set of grim A&E performance statistics issued on Friday by NHS England which have fuelled increasing fears that the health service is facing a winter crisis even before very cold weather has arrived.
Pressures on hospitals also meant that emergency departments recorded their second-worst performance against the politically important target that 95% of patients should be treated within four hours.
In the seven days to Sunday 7 December, the NHS across England treated then admitted or discharged, within four hours, 87.7% of the 286,429 patients who arrived at hospital A&E units. That compared with 90.4% the week before.
The highest-ever number of patients were also forced to spend between four and 12 hours on a trolley waiting to be admitted last week, in a further sign the service is struggling to meet the rising demand for care, despite ministers giving it an extra £700m from elsewhere in the Department of Health’s budget.
“Patients should be treated on the basis of clinical need rather than an arbitrary target, but these figures point to a system cracking under extreme pressure, with patient care suffering,” Porter said.
While the NHS has usually faced a spike in demand over the winter, “this year it’s experienced a spring, summer and autumn crisis as well, leaving no spare capacity in hospitals as we approach winter”.
Porter, a hospital doctor in Coventry, added: “This is not just a crisis in emergency care. Bed shortages and high numbers of patients inappropriately in hospital beds are now major stress factors on the system, leading to unacceptable delays in treating and discharging patients. Outside of hospitals, GP surgeries are struggling to cope with unprecedented levels of demand.”
Jeremy Hunt, the health secretary, hopes the extra £700m will help the NHS to hire more staff and increase its stock of beds to avoid coming under unsustainable pressure before May’s general election.
But Porter said there had been “a total failure by government to come up with a meaningful plan to deal with this”.
Labour called on ministers to set out new measures urgently to relieve the strain.
NHS England, which runs the service and allocates its £96bn budget, conceded that hospitals were being put under extra pressure and identified the rising number of attendances at A&E as a key reason.
It was “pulling out all the stops” to try to cope, it said.
In total, 35,373 patients waited more than four hours in what the NHS calls Type 1 A&E units – those at hospitals – before they were treated, the highest figure since records began in late 2010. The previous highest figure was 34,595 in April 2013, just after the problem-strewn launch of the NHS’s 111 telephone advice service led to a surge in demand.
Last week’s 35,373 is also more than 50% up on the 21,276 patients who waited more than four hours in the same week last year.
In addition, 7,760 patients who had been treated in A&E endured between four and 12 hours on a trolley as they waited to be admitted to hospital. That is more than 2,000 more people than the week before, and is further evidence that hospitals are facing mounting difficulties in dealing with the number of patients and complexity of illness and injury. It is also more than double the 3,666 patients who experienced a trolley wait in the same week in 2013.
The DH maintained that the NHS was well prepared to deal with winter and that the service had “robust plans” in place to cope.
“We know that the NHS is busier than ever before, which is why we’ve given the NHS a record £700m this winter for more doctors, nurses and beds,” a spokesman said. “The NHS has ensured that there are plans in every area to manage the extra demand.”
Dame Barbara Hakin, NHS England’s national director of commissioning operations, said: “This week [we had] over 110,100 emergency admissions to hospital and 436,229 attendances – up nearly 30,000 on the average for the same week over the past years. Unsurprisingly, this level of demand continues to put extra pressure on our hospitals.
“But the NHS remains resilient and is pulling out all the stops, with local hospitals, ambulances, GPs, home health services and local councils all working hard to open extra beds and seven-day services using the extra winter funding that has been made available.”
Andy Burnham, the shadow health secretary, said: “Last week was the worst week on record for patients waiting at A&E but the government is acting as if it’s not happening. Ministers can’t carry on like this. Labour has been warning the government for months about the growing crisis in A&E but it has failed to act. But even ministers must now accept that these figures are a worrying wake-up call.”
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