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A&E waiting times worsen across UK as winter begins to bite
Hospital A&E departments across the UK are failing to meet waiting time targets as seasonal pressures begin to mount, according to new figures.
The latest analysis of data from the Royal College of Emergency Medicine, submitted by more than 40 NHS trusts, indicates that 88% of A&E patients had been treated or admitted within four hours during the week commencing November 13. The NHS Four Hour Standard Performance target is 95%.
The RCEM began collating data for its Winter Flow Project seven weeks ago, at the beginning of October, with data relating to three key performance areas measured – delayed transfers of care, cancelled elective operations and A&E wait times.
It describes the latter as having “deteriorated consistently” since the beginning of October, when 92% of patients were managed within the four-hour limit.
Hospitals have also reported some difficulties managing patient transfer, with beds remaining occupied by patients deemed ready for discharge but who are unable to go home due to a shortage of social and community care services. However, the RCEM notes that 76% of monitored sites had taken steps to accommodate this – known as active bed management – where acute bed stock is adapted and sometimes increased to meet this changing demand.
The RCEM says that many trusts and boards had approached them following the winter of 2014/15 to say their greatest challenge in meeting the four-hour target had been this issue of bed availability as a consequence of delayed transfer, dubbed ‘bed blocking’.
It says that, despite the efforts of hospitals to respond to the issue of bed blocking this year and possibly as a result of the increasing demands being made on the system, the four-hour target is still being increasingly missed.
The analysis also found that over the seven-week period, a total of 6,300 elective operations had been cancelled, an average of 21 per week for each of the reporting trusts.
President of the RCEM, Dr Cliff Mann told the BBC that the "worst is yet to come". He says: "The majority of hospitals have endeavoured to increase the number of beds available to cope. Despite this, elective operations have had to be cancelled and postponed as bed capacity is insufficient to cope." He added that the problem of delayed discharge, which has been found to have contributed to an increase in declared major incidents, shows no sign of diminishing.
A spokeswoman for NHS England told the BBC that the it recognises the solution lies in the provision of more joined-up care – with improved links between the NHS and the social care system – an issue that is being prioritised.
“Dignity and compassion”
"It's important patients who are well enough to leave hospital can do so at the earliest opportunity and are helped to recover with dignity and compassion," the spokeswoman adds.
According to figures published during the summer by the Association of Directors of Adult Social Services, six consecutive years of budget cuts due to national austerity measures has meant that councils have been forced to collectively cut £4.6 billion from adult social care budgets since 2009/10. The consequence of such cuts has been described as a ‘black hole’ in social care, leaving tens of thousands of disabled and elderly people with no access or restricted access to help with basic tasks, such as washing, dressing and cooking.
Separately, figures published in recent days by the Office for National Statistics indicate that death rates for last winter were the highest since 1999, with 44,000 more deaths above the seasonal average. 36,000 of those who died were aged 75 or over and a third of the total deaths were said to from respiratory-related causes.
The spike has been widely attributed to what has been described as an ‘ineffective’ flu vaccine.
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