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NHS A&E Performance Worst Ever

January 10, 2020 11:27 PM

Publication of NHS statistics for December show that one in five people in A&E are now waiting over four hours to be seen. This compares with a target of 1 in 20 failures, a target last met at the end of the Coalition period in 2015. This follows poor performance in October and November which at the time were also the worst months performance ever recorded since statistics were first published in 2004. These results come despite some hospitals cancelling routine operations to reduce stress on the system

A key problem seems to have been a shortage of beds on wards. Nearly 100,000 of the sickest patients were forced to spend over four hours on trolleys and in corridors after their time in A&E as beds could not be found. More than 2,000 people waited upwards of 12 hours for a hospital bed, a huge rise on the 284 who endured similar wait times in December 2018.

Bed numbers have been falling since the 1970s as new medical techniques have seen shorter stays. With an aging population however it seems this cost saving measure has now gone too far
The King's Fund is an independent charity working to improve health and care in England in a recent report https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers has found that the UK has fewer acute hospital beds per 1,000 inhabitants than other advanced health systems. In 2014 the UK had around 2.3 acute beds per 1,000 inhabitants, compared to the EU-15 average of 3.7 acute beds per 1,000 (among those for which data is available).

The Kings Fund concluded "In England, data on overnight hospital bed occupancy is available from 2010/11 and has risen from an average of 87.1 per cent in 2010/11 to 90.3 per cent in 2016/17 Between January and March of 2017, it reached 91.4 per cent - the highest recorded for any quarter.
There are signs of a growing shortage of beds, as can be seen in extremely high levels of average bed occupancy and stubbornly large numbers of delayed transfers of care. There are also specific concerns about bed stock in mental health, with the Royal College of Psychiatrists warning of a 'national crisis' resulting in more patients needing to be sent out of area for treatment . Current levels of occupancy mean the average hospital in England is at risk of being unable to effectively manage patient flow leaving it vulnerable to fluctuations in demand"

At the last election Boris Johnson made much of how he could be trusted with the NHS. He managed to gloss over the fact that the service performance was a consequence of almost 9 years of Tory led decisions to squeeze investment, discourage nurse training (through abolished bursaries) and poor staff retention ( by capping pay rises). He has nowhere to hide now. Hopefully the only way for performance is up but we shall see!