The NHS is battling record numbers of patients facing 12-hour waits in A&E for a hospital bed, according to the latest figures. It comes after the decision to admit them to a ward, meaning they will already have likely waited for an ambulance and then while being assessed when they arrived at A&E.
The latest monthly performance figures published by NHS England for April 2022 reveal that 24,138 patients who attended major emergency departments were delayed for 12 hours or more from the decision to admit to getting a bed on a ward. This is the highest number of 12-hour waits on record for England, and is a seven per cent increase in 12-hour waits compared to the previous month, March 2022, which also saw a record high.
The shocking figures also show that the 79,606 12-hour waits from the decision to admit recorded so far in 2022 is just 3,250 fewer than the total recorded between August 2010 and December 2021 - which stands at 82,856.
Leading medics say the concerning numbers demonstrate that the ‘crisis in urgent and emergency care continues to deteriorate’, as the situation becomes ‘more serious than it has ever been’. Dr Katherine Henderson, President of the Royal College of Emergency Medicine (RCEM), said: “The crisis in urgent and emergency care continues to deteriorate.
“The data show 24,000 patients were delayed in an emergency department for 12 hours or more from [the] decision to admit to admission. This is a staggering and grim number and should seriously alarm all political and health leaders.
“Patients are coming to harm; now is the time for an urgent and emergency care plan to tackle this crisis.
“The situation is more serious than it has ever been. Patients face long waits for an ambulance, long waits in an ambulance outside an emergency department, and long waits in the emergency department. These long waits delay care and treatment to patients who may be in a critical condition, and they prevent our highly skilled paramedics from returning to the community and responding to urgent and emergency calls.”
Four-hour performance at major emergency departments was only 59 per cent, the latest figures also show. This is the second worst four-hour performance on record, says the RCEM, with more than two in five patients delayed by four hours or more when seeking treatment.
Across England, 131,905 patients spent more than four hours in an emergency department from decision to admit to admission in April, this means that more than one in three emergency admissions experienced waits of four hours or more from decision to admit, often referred to as ‘trolley waits’.
Nearly one in four booked appointments were not seen within four hours at major emergency departments, this is the second worst booked appointment data on record, adds the RCEM.
NHS England has said that it has performed a record number of diagnostic tests in March in the ‘most ambitious catch up plan in NHS history’ to bring down the number of longest waits for planned operations, which have been heavily delayed during the pandemic, known as ‘elective procedures’.
The latest monthly performance data, published today, show more than two million diagnostic tests were carried out - the highest total for March on record - and an increase of 217,000 on the previous month.
It was also the highest month on record for cancer referrals, with 253,796 people checked in March alone - an almost 40 per cent increase on the number of checks made in March 2020. 28,378 people started treatment for cancer, the second highest number on record. This is second only to March 2020, when 28,881 people started treatment.
The total waiting list now stands at 6.36 million, and increasing numbers of people are coming forward in the wake of the pandemic, with 1.78 million people being referred for treatment in March.
The number of people waiting more than two years for elective treatment has dropped by almost 6,500 between February and March, while those waiting more than 78 weeks – a year and a half - dropped by 5,700 in the same period.
Covid cases are too reducing, but the national NHS governance body admits that pressure on urgent and emergency care continues. April 2022 had more life-threatening ambulance call-outs (78,582) and 999 calls answered (860,414) than the same month in all previous years, says NHS England. A&Es also saw the second busiest April on record, with more than two million people attending and 480,000 admissions.
Overall, emergency admissions in the past 12 months are up 9.8 per cent on the preceding 12-month period.
Bed capacity also is constrained with 94 per cent of adult general and acute beds occupied in April nationally. Greater Manchester health leaders have told the Manchester Evening News that anything over 85 per cent of beds occupied for the region’s hospital is ‘extremely uncomfortable’.
During April, almost 12,589 beds were taken up on average each day by patients who no longer needed to be in hospital but cannot be discharged due to pressures outside of hospital, including in social care.
Professor Stephen Powis, national medical director for NHS England, said: “Today’s figures show our hardworking teams across the NHS are making good progress in tackling the backlogs that have built up with record numbers of diagnostic tests and cancer checks taking place in March, as part of the most ambitious catch up plan in NHS history.
“We always knew the waiting list would initially continue to grow as more people come forward for care who may have held off during the pandemic, but today’s data show the number of people waiting more than two years has fallen for the second month in a row, and the number waiting more than 18 months has gone down for the first time.
“There is no doubt the NHS still faces pressures, and the latest figures are another reminder of the crucial importance of community and social care, in helping people in hospital leave when they are fit to do so, not just because it is better for them but because it helps free up precious NHS bed space.”
There’s just not enough beds, say doctors. “At the heart of the issue are reduced bed capacity in hospitals mixed with an increase in the number of long-stay patients – social care patients who do not have sufficient support to return home or to the community - and widespread workforce shortages throughout the system,” continued Dr Henderson.
“To tackle the crisis the government must publish a fully funded workforce plan that includes measures to retain existing staff, and open 10,000 more beds across the UK.”
Responding to the government’s announcement of more funding for nursing in care homes, Dr Henderson added: “This announcement is welcome. Social care nurses have long been undervalued and under-acknowledged. This increase in pay is a welcome step towards showing them the appreciation and gratitude they highly deserve.
“However, it is a shame to see that this increase in funding is limited to NHS-funded nursing care. The entire social care workforce deserves the same acknowledgement and reward. It is critical that during this crisis we attract and retain social care workers and value their time and effort by paying a wage that reflects the significance of their role.
“Good social care supports an efficient health service. Good social care can help prevent A&E attendances. Good social care will support patients moving in and out of hospital in a timely way. Crucially, good social care frees up space for other patients and increases flow throughout the hospital.”
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