A&E patients now face longest waiting times in a decade

THE FULL SCALE of the crisis gripping the NHS has been exposed as new figures show A&E waiting times have plummeted to their worst levels in a decade.

Health minister Norman Lamb

Prime Minister David Cameron was forced to admit services were under pressure, amid claims from unions the NHS was “on the brink of disaster”. A senior doctor warned it was “running absolutely red hot”.

Scarborough hospital bosses today stood down a “major incident” called when it reached full capacity but a number of other hospitals in England went on full alert due to surging demand for emergency care.

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Nationally only 92.6 per cent of A&E patients were seen within the four-hour target time between October and December, below the 95 per cent standard, but this fell to fewer than four in five in Hull – the third worst performance in the country. Only two of 15 NHS trusts serving the region hit the target over the period. Unions blamed staff shortages and cuts to social care.

Mr Cameron insisted around 2,500 more patients were being seen within four hours every day than four years ago. “A lot of the pressure on A&E is coming from frail, elderly people, often with many different health conditions and the best place for them, frankly, is not A&E,” he said.

He accused union Unison or trying to “scaremonger” after it claimed the NHS is “on the brink of disaster”.

He added: “The fact is the NHS is coping with a huge amount.”

But Shadow Health Secretary Andy Burnham said: “This crisis in A&E has its roots in the Government’s cuts to social care and GP access and its disastrous decision to throw the NHS into the chaos of reorganisation. It is yet more proof that the NHS as you know it won’t survive another five years of David Cameron.”

Peter Carter, chief executive of the Royal College of Nursing, added: “The Government needs to stop burying its head in the sand and accept that there is a crisis in A&E, which is getting worse.”

Richard Hawkes, chairman of the Care and Support Alliance, representing more than 75 charities, said: “These statistics reflect the huge pressure not just on the health service but also the ongoing squeeze in council-funded social care. Chronic under-funding has left hundreds of thousands of older and disabled people, who need support to do the basics, like getting up or out of the house, cut out of the care system.”

Prof Keith Willett, NHS England’s director for acute episodes of care, said the system was “running absolutely red hot”. Ambulance services had recorded a 25 per cent increase in 999 calls and there had been a 20 per cent increase in patients whose hospital discharge had been delayed, partly due to “substantial reductions” in funding for social services, he said.

Bosses at Scarborough’s hospital are planning to recruit more nurses in Spain to fill gaps in staffing. They said they could open new beds if they were able to find more staff. Their problems had been exacerbated by vacancies for 30 nurses but they plan to recruit 40 more in a drive next month.

The hospital has also been hit by shortages of A&E specialists, and faces long-standing problems to recruit junior doctors to its casualty units. The Yorkshire Post can reveal they are now being offered 20 per cent premiums on their pay packages to work at both Scarborough and York hospitals.

Latest figures reveal the York Teaching Hospital NHS Foundation Trust, which runs both hospitals, treated 89.4 per cent of A&E patients within four hours in the three months to December, significantly below the target time of 95 per cent target, which was cut from 98 per cent by the coalition Government in 2010.

A&E and other treatment centres in Sheffield saw 89.3 per cent within the target time but the worst performance in Yorkshire was in Hull where only 79.1 per cent of patients were seen within four hours. Only NHS trusts in Cambridge and Medway in Kent performed worse over the three months.

Mike Proctor, deputy chief executive at the York trust, said he could open an extra ward in Scarborough if more nurses were available but not enough people had been trained.

He said: “If I could recruit those nurses, and I want to recruit those nurses and I’ve got the money to recruit those nurses, I could open an additional ward and that would make all the difference. It’s been very difficult to recruit those people to Scarborough, it’s a national shortage, and so we would be in a better position if I could recruit to every vacancy we’ve got and I tell you I’m trying.”

Mr Proctor praised his staff for coping with the excess demand at the hospital, which saw all beds and escalation areas full, 18 patients being treated in the emergency department and more patients waiting for beds at 7.30am on Monday.

He said: “We kept all our patients safe and all our patients cared for and I’m really proud of our staff for being able to do that.”

But Unison Yorkshire regional organiser Ray Gray said hospital staff were at “breaking point”.

He said the situation at Scarborough was not unusual and other hospitals in the region were facing similar pressures.

“We have to ask why this is happening. I’m told a third of patients at Scarborough A&E should have been going somewhere else but they haven’t got access to GPs,” he said. “I don’t blame the organisations. However you look at it, it comes down to Government funding.”

A spokesman for Hull and East Yorkshire Hospitals NHS Trust said there had been a steady rise in numbers of people visiting A&E which now saw 300 people a day on average.

“We have also experienced other difficulties, such as delays in discharging patients, which have made meeting the 95 per cent standard a particular challenge,” he added.

Its A&E was being revamped in a £7m project which would double its capacity and other changes were planned which would lead to a “steady improvement” in its performance.

David Throssell, medical director at Sheffield Teaching Hospitals NHS Foundation Trust, said nearly 4,000 patients had been admitted to its hospitals in December, up from 3,500 in 2013.

He said: “The issue is not just about the number of people coming to A&E, it is also the significant increase in the number of sick people who need to be admitted to a ward.”

NHS EMERGENCY WAIT TIMES BY NUMBERS

• The target: The Government wants 95% of patients to be transferred, admitted or discharged within four hours of arriving at accident & emergency departments

• The challenge: There were 5,573,644 attendances at A&E departments across England in the October-December 2014 quarter, up from 5,294,269 during the corresponding period in 2013

• Record-long waits: The four-hour rule was met for 92.6% of English A&E patients this quarter - the poorest showing in a decade - down from 95.6% during the corresponding period in 2013

• Where people waited: Cambridge University Hospitals NHS Foundation Trust in East Anglia had 75.2% of its A&E patients in and out of the department within four hours this quarter, compared with 79% of emergency department patients at Medway NHS Foundation Trust hospitals in England’s South East and 79.1% of A&E attendees seen by Hull And East Yorkshire Hospitals NHS Trust

• The biggest blow-out: The University Hospitals Of North Midlands NHS Trust had 100 emergency patients who waited more than 12 hours to be admitted once the decision to admit them was made

• The toughest week: Across England in the last week before Christmas - the week ending on December 21, 2014 - only 88.8% of emergency patients were dealt with within the recommended four-hour window.