A&Es under strain as patients face longer wait for treatment

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NEW figures have revealed growing signs of pressure on A&E units.

Numbers of patients seen within four hours of arriving in casualty are at their lowest level since April.

Figures for England show 94.3 per cent of patients were seen within four hours in the week ending January 5, against a national target of 95 per cent.

In major A&E departments, the figure was also at its lowest level since April, with 91.5 per cent of patients seen within four hours.

The figures come despite a drop in attendances at A&E, with visits down compared with a normal winter week.

Around two thirds of the 144 trusts that operate major A&E departments are now missing the target.

The deterioration comes after it was revealed that a watchdog had raised concerns about shortages of doctors and nurses in casualty at Bradford Royal Infirmary, triggering an investigation by regulator Monitor.

Staffing problems were also identified on a number of other wards in two snap inspections by the Care Quality Commission, with shortages in A&E leading to delays in assessing injuries and illness and overcrowding at busy times which affected patients’ privacy.

The four-hour target is regularly missed by hospitals during the winter months. It cover all centres – major A&Es, smaller minor injury units and NHS urgent care centres.

NHS England chief operating officer Dame Barbara Hakin said: “Despite the traditional pressures on health services in the weeks after Christmas, the NHS continues to deliver for patients.

“The first few weeks of the calendar year are generally the toughest for the NHS, but this week’s figures, the first week in quarter four, are over a percentage point better than the same week last year. This is hugely encouraging for patients and follows an excellent performance over the Christmas holiday period.

“All this suggests that the NHS has prepared well and pulled out all the stops on behalf of the public.”

Dame Barbara, a former GP in Bradford, said there were 2,674 more emergency admissions than the same week last year, though overall A&E attendances are falling.

She said handover delays between ambulances and casualty staff were down significantly compared with 12 months ago, and there had been a fall in numbers of cancelled operations.

But there had been an increase in delayed transfers of care from hospital to the community and she said local health officials had been asked to “redouble their efforts” to tackle the problem.

Shadow Health Secretary Andy Burnham said the declining performance should “set alarm bells ringing in 10 Downing Street”.

“Experts warned the Government about the A&E crisis but they refused to listen. Just weeks after Ministers said ‘the crisis is behind us’, patients have experienced the worst week in A&E so far this winter,” he said.

“David Cameron’s fingerprints are all over this crisis. He wasted billions on an unnecessary reorganisation and threw the NHS into chaos. He’s made it harder to get a GP appointment, closed a quarter of NHS walk-in centres and made deep cuts to social care support – all the ingredients for the current pressures on A&E.”

A Department of Health spokesman said: “The NHS has missed its A&E target in the first week of January every year for the past decade. We know winter can be tough. That’s why we’ve taken early action to help the NHS cope, investing £400m in alleviating short-term pressures and A&E performance is better than this time last year.

“The vast majority of patients continue to get the excellent care they deserve.”