NHS in England: Four hour emergency department target hits record low
BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2719 (Published 10 November 2022) Cite this as: BMJ 2022;379:o2719
The performance of accident and emergency departments in England hit a record low in October with fewer than 70% of patients seen within the target four hours for the first time since records began in 2004, according to the latest official data.
NHS England, however, has highlighted a 60% drop in the numbers of people having to wait for 18 months or longer for routine treatment.
The latest monthly NHS performance data1 for emergency departments showed a mixed picture but one dominated by worsening achievements in the NHS overall.
Just 69.3% of people attending emergency departments were seen in under four hours in October, a fall from 71% in September and well below the 95% target. Some 43 792 patients waited more than 12 hours in emergency departments to be admitted to hospital (the highest on record) in October—up 34% from 32 776 in September.
Elective times were also poor, as other new data2 show there were 7.1 million people in England waiting to begin hospital treatment at the end of September—up from 6.8 million in July, which includes more than 400 000 people who had been waiting for more than a year.
Additional data3 on cancer showed that in September only 61.3% of newly diagnosed patients were starting treatment within two months—the worst performance on the national target which is for 100%.
NHS England said that staff had faced the busiest October ever for emergency department attendances and the most serious ambulance callouts.
It focused on positive developments, highlighting that the NHS had reduced the number of people waiting 18 months for treatment by almost 60% in one year. The number of patients waiting 78 weeks was reduced by 73 430 from 123 969 compared with September 2021 in a drive to prioritise the longest waits.
NHS medical director Stephen Powis said, “There is no doubt October has been a challenging month for staff who are now facing a ‘tripledemic’ of covid, flu, and record pressure on emergency services with more people attending emergency departments or requiring the most urgent ambulance callouts than any other October.
“Pressure on emergency services remains high as a result of more than 13 000 beds taken up each day by people who no longer need to be in hospital. But staff have kept their foot on the accelerator to get the backlog down with 18 month waiters down by three fifths on last year.”
Worse to come
Siva Anandaciva, chief analyst at health thinktank the King’s Fund, said, “Just days before the autumn budget statement, today’s figures present government with an uncomfortable truth: many NHS services are already in crisis and the situation is likely to worsen as winter bites and demoralised staff show their discontent through industrial action.
“The government’s upcoming fiscal statement will have a profound impact on the quality and accessibility of health and care services for patients in the coming years.”
Matthew Taylor, chief executive of the NHS Confederation, which represents NHS organisations, said, “The NHS continues to operate under huge pressure but has made progress in meeting rising demand for care.
“However, NHS staff are being let down by the fact the government has still not given local services the £500m that was promised two months ago. The failure to provide extra capacity in social care through this £500m fund is causing bottlenecks on hospital wards, all the way back to emergency departments and ambulances queuing outside hospitals.”