A&E performance was the worst ever during the seven days to last Sunday. Photograph: Ik Aldama/ Ik Aldama/Demotix/Corbis
Hospital A&E performance sank to a fresh low over the new year, with NHS England statistics showing that emergency departments across England managed to treat just 79.8% of patients within the four-hour target.
The performance during the seven days to last Sunday was officially the worst ever. The figures, released three days after the publication of data showing that A&E waiting time performance had slumped just before Christmas, put the coalition under renewed pressure over the NHS.
Other figures from NHS England, which reveal a sharp escalation in other problems over the festive period, especially in the week including and just after the new year, indicate the service was on the brink of a winter crisis.
Ambulances had to queue for at least 30 minutes outside an A&E unit in England on 29,388 occasions in the three weeks between 15 December and 4 January, unable to hand over their patients to A&E staff because the emergency department was too busy.
That was more than double the 12,615 such incidents in the comparable three weeks in the winter of 2013-14.
Dr Mark Porter, head of the British Medical Association and leader of Britain’s doctors, said the deepening difficulties in A&E were the result of intense pressures on other parts of the NHS, especially GP services, and inadequate social care.
“Problems at the hospital front door are often linked to delays at the back door,” he said. “A shortage of social care beds creates exit block in hospitals, meaning patients can’t be discharged because there is simply nowhere for them to go.
“This, coupled with a shortage of hospital beds, leads to patients waiting for hours on trolleys or admitted to an inappropriate ward for their needs, affecting the quality of care they receive.”
Far more postponements of planned operations, such as hernia repairs and cataract removals, occurred over the three-week period because of the huge pressure on hospitals. In all, 3,771 elective procedures were called off, compared with 2,016 the year before . The number of patients that had to be diverted to another A&E unit also rose, from 39 to 75.
Bedblocking, which makes it harder for hospitals to admit new patients through A&E, reached record levels. Over the three weeks 43,426 beds were occupied by mainly frail, elderly patients who could not be safely discharged, despite doctors having passed them as medically fit to go, because of a lack of social care provision. That was significantly up on the 33,055 delayed transfers in the same period last winter.
Despite the intense pressure, no A&E unit had to close temporarily, which occurs when a hospital cannot cope. Two A&Es have had to shut their doors to patients this winter, though none since 11 December.
Last weekend – 2, 3 and 4 January – saw some of the worst-ever performances by the NHS on these other indicators.
That may be because many GP surgeries were closed or because hospital staff were on holiday, or other factors.
For example, over those three days, ambulances had to queue outside A&E units for at least half an hour on 4,848 occasions, while 33 hospital trusts experienced what NHS England calls operational problems, trying to cope with demand.
Over the weekend 775 beds were closed due to norovirus, the winter vomiting bug, 373 elective and 14 urgent operations had to be cancelled and 10 patients had to be diverted to another A&E unit.
And in all 3,741 beds were unable to be used for newly arrived patients last weekend because of bedblocking.
Earlier in the week, David Cameron denied that the NHS was in crisis, despite claims to the contrary by Labour, the Royal College of Nursing and senior doctors.
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