Only ONE NHS trust hit the target of seeing 95% of A&E patients within four hours in 2019 (so how badly did YOUR local hospital perform?)
- NHS figures for 2019 show 24 hospital trusts treated fewer than 80% in time
- Yeovil District Hospital was the only one to hit the 95% target over the year
- Stepping Hill Hospital in Stockport, Greater Manchester, managed only 70%
- Experts told MailOnline NHS patients face ‘undignified’ and ‘risky’ conditions
Only one hospital trust in England treated its A&E patients within the NHS time target last year, MailOnline can reveal.
Yeovil District Hospital was the only place that managed to process 95 per cent of its patients within four hours of their arrival. Its average for the year was 96.3 per cent.
Statistics analysed by this website reveal that 117 comparable hospitals across the country all missed the mark.
The worst performing trust, in Stockport, Greater Manchester, completed just 70.3 per cent of visits in time, meaning almost a third of its patients waited for longer.
Doctors said the damning figures show the health service has ‘deteriorated’ and people now face ‘undignified’ and ‘risky’ conditions when they seek medical help.
Health Secretary Matt Hancock yesterday sparked a row by hinting that the four-hour standard, set in its current form in 2010, could be scrapped completely.
But critics say this would amount to ‘moving the goalposts’ and just hide the dire conditions behind English hospital doors.
Yeovil District Hospital, in Somerset, is run by the only NHS trust in England which managed to process 95 per cent of its A&E patients within the NHS’s four-hour target time in 2019
Annual averages of monthly A&E performances revealed 24 trusts – each of which runs at least one emergency department – posted figures below 80 per cent.
A further 75 trusts processed between 80 and 90 per cent of their patients within four hours, meaning one in 10 at those hospitals waited for longer.
And 19, including Yeovil, managed more than 90 per cent.
Yeovil District Hospital had a relatively low number of patients – around 85,000 – but three of the worst-performing trusts had even fewer than that.
Longer waits in A&E can be distressing for patients and potentially let them deteriorate before they’re seen by a doctor, but they also hold up ambulance crews who are supposed to be in and out of the hospital within 15 minutes.
‘These figures show clearly how our health service has deteriorated, despite the best efforts of an understaffed and overstretched workforce,’ Dr Katherine Henderson, president of the Royal College of Emergency Medicine, told MailOnline.
‘Conditions for patients are getting worse; thousands now have to stay long periods on trollies in corridors or in the back of an ambulance that cannot offload.
‘This is undignified and puts lives at risk.’
Dr Susan Crossland, the president of the Acute Society of Medicine, added: ‘I think the fact that only one trust have met the target in 2019 shows the intense pressure acute and emergency services have been under for a sustained period.
‘And despite us constantly asking for better planning, further resources and better staffing, we have been asked to continue providing the same level of safe care with ever decreasing resources. I hope Mr Hancock will listen.’
A geographical breakdown of the figures shows that, behind Stockport, the worst-performing trusts last year were Shrewsbury and Telford (73.91 per cent); the Princess Alexandra in Essex (74.9 per cent); Bradford Teaching Hospitals (75.18 per cent) and Worcestershire Acute Hospitals (75.41 per cent).
The Princess Alexandra refuted the NHS statistics and said its true figure was 75.04 per cent within four hours, which does not change its ranking.
Stockport NHS trust, which runs Stepping Hill Hospital (pictured), had the worst performing emergency department in England last year, with only 70 per cent of its patients getting discharged or admitted within four hours
At the other end of the scale, the best performers, after Yeovil, were Surrey and Sussex Healthcare (94.3 per cent); the Newcastle upon Tyne Hospitals (94.12 per cent); Northumbria Healthcare (93.89 per cent) and Homerton University Hospital in London (93.59 per cent).
The figures are revealed after Health Secretary Matt Hancock yesterday said in a radio interview that the four-hour target is not ‘clinically appropriate’.
He told BBC Radio 5 Live: ‘The problem with that target is that, increasingly, people can be treated on the day and able to go home.
‘That is much better for the patient and also better for the NHS, and yet the way that’s counted in the target doesn’t work.’
Mr Hancock implied that people who get treated on the spot are likely to spill over the four-hour target but ultimately put less pressure on a hospital than someone who is processed in an hour but spends the night on a ward.
The NHS as a whole has not hit the 95 per cent target for almost five years – it last succeeded in July 2015.
And a trial is under way in 14 hospitals – which weren’t counted in today’s data – to record A&E waits in a different way, which Mr Hancock hinted could be the future.
Doctors’ organisations, however, say there is no evidence that the trial method is at all suitable and they have called for the testing to be stopped.
WHERE DID A&E DEPARTMENTS PERFORM BEST IN 2019?
(Percentage of patients treated, discharged or admitted within four hours)
Source: NHS England monthly A&E attendance reports
WHERE DID A&E DEPARTMENTS PERFORM WORST IN 2019?
(Percentage of patients treated, discharged or admitted within four hours)
Source: NHS England monthly A&E attendance reports
Health Secretary Matt Hancock said ‘targets have to be clinically appropriate’, and suggested the four-hour A&E wait standard might be scrapped in favour of basing visits on priority
Dr Simon Walsh, an emergency medicine expert at the British Medical Association, said yesterday that replacing targets ‘does not address fundamental issues’.
‘Targets are an important indicator when services are struggling,’ he said, ‘and there is a very real concern that any change to targets will effectively mask underperformance and the effects of the decisions that politicians make about resourcing the NHS.’
And Labour’s Shadow Health Secretary, Jonathan Ashworth, added: ‘Changing the A&E target won’t magic away the problems in our overcrowded hospitals, with patients left on trolleys in corridors for hours and hours.
WHAT IS THE NHS’S FOUR-HOUR A&E TARGET?
The NHS’s four-hour A&E target is one set out in the NHS constitution which dictates 95 per cent of all emergency patients in England should be admitted to hospital or discharged within four hours of arriving.
Hospitals’ performance against this measure has been tracked for more than a decade.
At a national level the NHS hasn’t hit the 95 per cent target since July 2015, when it was 95.2 per cent.
Since then there has been a steady decline to October 2019’s record low of 83.6 per cent.
That low meant that one out of every six people who went to A&E in that month waited there for more than four hours – more than 320,000 people.
The woeful figures come at a time when the NHS is trying to scrap the four-hour target completely.
Unable to meet the ambitious 95 per cent, the health service is now trying to switch to a system which doesn’t measure waiting times against a set benchmark but simply tries to treat the more urgent cases faster and loosens the limit for less serious patients.
‘Any review of targets must be transparent and based on watertight clinical evidence.
‘Otherwise patients will think Matt Hancock is trying to move the goalposts to avoid scrutiny of the government’s record.’
The A&E wait statistics come as the health service faced a torrid year.
Ambulance delays this winter have been more frequent and lengthy than at any time in the past two years.
In the first week of January, one in five ambulance patients (18 per cent) had to wait half an hour or more to be handed over to hospital staff.
And the waiting list for planned surgery last year soared to its highest level ever – there are now 4.42million people waiting for operations.
But hospitals are so busy many of these operations are being cancelled and a recent survey found four out of 10 surgeons have had to change their procedures because patients’ conditions got worse during a long wait.
NHS Providers, an internal body that represents hospital and ambulance staff, said the current pressure is unsustainable.
Its policy director, Miriam Deakin, said today: ‘Trusts are working flat out to provide high-quality care to more patients seeking emergency care than ever before.
‘It is clear from the deterioration of performance against the four-hour standard that the demand which used to be confined to the winter months is now seen all year-round.
‘Running hospitals at boiling point like this is unsustainable.’
Stockport NHS Trust, which came off worst in today’s figures, has apologised to people who use its hospital.
The chief executive, Louise Robson, said: ‘I’d like to apologise to local people who have experienced long waits in our A&E and any family, friends and carers who attended with them. This experience is not what we want for our patients.
‘In our area we serve a population that has a high portion of older people, who are often frail with complex conditions and they place a particular demand on our emergency services.
‘Our staff work tirelessly in very busy conditions to ensure that the people who need our support receive good quality care.
‘In response to current pressures we have recently opened 57 extra beds, and we are continuing to work closely with colleagues across the health and care system on longer term solutions to the pressures our services face. The public can help by only visiting our A&E if it is a genuine emergency.’
A spokesperson for Yeovil District Hospital, the best performer, said: ‘Our ability to meet the four-hour standard is due to a whole hospital approach, which recognises a vital role for each department, not just our A&E.
‘Assessing and treating patients in A&E, and admitting them when necessary, relies upon every part of the hospital working together, and with social care, to ensure the patient is in the right place and getting the right care for their needs.’
The annual average statistics were calculated using acute trust footprint data, recorded by NHS England, which accounts for all emergency departments run by a trust.
WHAT DID HOSPITAL BOSSES HAVE TO SAY ABOUT THEIR PERFORMANCE?
Shrewsbury and Telford Hospital NHS Trust (70.31 per cent)
Sara Biffen, deputy chief operating officer at the Shrewsbury and Telford Hospital NHS Trust, said: ‘Our doctors, nurses and other staff are working hard to provide the best possible care while we still see very high demand on our services. We are sorry that this means some patients waiting longer than they should in our A&Es or a place on a ward.
‘To ensure patients are seen and treated as quickly as possible, additional cubicles have been opened and additional bed space has been created on a number of wards.
‘In the longer term, the trust will have a 25-bed therapy-led ward/discharge lounge open at the Royal Shrewsbury Hospital and a 16-bed ward at the Princess Royal Hospital in Telford in the coming weeks.’
Isle of Wight NHS Trust (76.52 per cent)
‘Our new Urgent Treatment Centre, which treats people with minor illness and injury, is relieving some of the pressure on the Emergency Department.
‘Supporting people to leave hospital as soon as they are able to is an important part of improving our performance against the national targets for Urgent and Emergency Care.
‘We apologise unreservedly to anyone who may have experienced a long wait and want to reassure our community that we are working really hard see and treat people as quickly as possible.’
Princess Alexandra Hospital NHS Trust (74.9 per cent NHS; 75.04 per cent internal)
Stephanie Lawton, chief operating officer, said: ‘We have experienced a very high demand on our emergency department and across the hospital over the last year. Our dedicated teams continue to work hard to assess, treat and admit patients and ensure that those who are well enough can leave hospital and return home.
‘We are continuing our work with local health and social care partners, with year-round planning for resilience across the system. This includes the opening of our additional inpatient ward (the winter escalation ward) at Princess Alexandra Hospital and additional intermediate care beds in west Essex.’
Mid Cheshire Hospitals NHS Foundation Trust (77.36 per cent)
‘A&Es across the country have seen an increase in attendances over the last year and Leighton Hospital is no exception – we have witnessed around 500 more people a month attend A&E, which is more than double the national average.
‘To help keep up with demand, we have opened additional beds, invested heavily in our Emergency Department’s workforce and have recently expanded Leighton Hospital’s A&E.
‘Staff across the Trust continue to work hard to ensure patient safety and that services run as smoothly as possible. Recent demand has meant, however, that some patients have had to wait longer than usual to be treated and we would like to apologise to those affected.’
Norfolk & Norwich University Hospitals NHS Trust (76.2 per cent)
Sam Higginson, chief executive, said: ‘We have seen a more than 25% increase in emergency attendances over the last four years and our staff are working really hard to assess and treat patients as quickly as possible to provide safe and appropriate care.
‘We are taking a number of steps to help manage the extra demand, such as opening escalation beds, increasing staffing levels and developing the roles of advanced nursing and allied health professionals.
‘We are also building a new ward block which will provide 68 new beds to help improve patient flow from our Emergency Department and this will be open in the spring.’
Wye Valley NHS Trust (77.02 per cent)
‘Every acute NHS Trust in the country is expected to meet the A&E four-hour wait performance standard. The reality is that very few are.
‘We have managed … extra demand both by creating more capacity and redesigning the emergency care pathways, which means that more patients are treated with same day emergency care and reduced length of stay by community services redesign.
‘We opened a new 24 bedded Acute Medical Unit just over 12 months ago, which allows us to see and treat patients more quickly.
‘The Trust has significantly improved its performance regarding admitting patients within 4 hours of their arrival as 3,111 more attendances were admitted into acute beds within the measure in 2019 than 2018.
‘Further to this, we have announced that £23.6 million funding has been earmarked for the planned hutted ward replacement project, which will help to ease pressure on bed capacity when the new wards open in 2020, an additional 18 bed capacity is being built into the planning.’
Worcestershire Acute Hospitals NHS Trust (75.41 per cent)
Matthew Hopkins, chief executive, said: ‘Our doctors, nurses and other staff are working hard to provide care for a significantly higher than usual number of people, and we regret that this means some patients are waiting longer than they should for care in A&E or a place on a ward.
‘We have taken steps to make sure we see patients as quickly as we can, prioritising those who are most unwell.’
Bradford Teaching Hospitals NHS Foundation Trust (75.18 per cent)
‘Our staff are working extremely hard and have shown great support, flexibility and commitment to ensure our patients continue to receive the best possible care in very challenging circumstances.’
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