NHS England and DoH accused of trying to ‘keep patients in the dark’ on NHS performance as winter pressures mount

NHS Performance

NHS England is dropping the publication of key NHS performance figures, relied upon as snapshot of how well the service is coping with seasonal pressures from week-to-week, in favour of a monthly bulletin.

The controversial move means that key performance indicators – including A&E waiting times, trolley waiting times, ambulance delays, delayed discharges and cancelled operations – will now be published monthly with a six-week delay.

In addition, the official winter reporting period, which has previously begun at the end of November to the end of March, has been shortened by a month, which, say critics, makes comparative year-on-year analysis more difficult.

“Keeping patients in the dark”

Shadow Health Secretary Heidi Alexander told The Independent that there was “no justification for keeping patients in the dark about how their local health services are performing”. She adds that, with the backing of Labour leader Jeremy Corbyn, she has written to Jeremy Hunt to demand the weekly figures be reinstated.

“Heading for a tough winter”

The move comes as an increasing number of experts are voicing concerns that pressure on the NHS this winter could be at its worst in five years, said to be due in part to staff shortages and a reduction of costly agency staff.

Independent health care charity the Nuffield Trust’s chief executive, Nigel Edwards, says he is concerned that the decision could mean data relating to areas of excessive pressure over winter will be released too late for remedial action to be taken.

He says: “All the indicators from the most recent set of performance statistics in September were that the health service is heading for a tough winter, with the figures showing that the four-hour waiting time in A&E was not met again, and that delayed transfers of care days had increased by almost 10,000 in a year.

“It’s important for individual trusts to be able to check quickly whether their performance is out of step with that of others, and for areas of the system where excessive pressure is being felt to become clear quickly.

“I am worried that only publishing figures monthly on indicators like waits in A&E and cancelled operations won’t provide this clarity quickly enough.”

Accident and Emergency

Chief economist at the King’s Fund, John Appleby, says that the change “appears to undermine the Government’s message about increasing transparency and making better use of data, and will reduce understanding across the health system about the impact of winter pressures”.

An NHS England spokesperson defended the change, saying: “We will be publishing on a monthly basis a full and comprehensive set of data on NHS performance for the public throughout the year, including this winter.

“This will include the normal measures such as the four-hour waiting standard and delays in transferring patients. The advantage is that doing this gives people a complete picture while also smoothing out week-to-week fluctuations which can be misleading.”

Winter Flow Project

Performance continues to be monitored separately by the Royal College of Emergency Medicine under its Winter Flow Project, using data from more than 40 Trusts relating to three key areas.

The RCEM recently revealed that A&E waiting times had “deteriorated consistently” since October after its figures for November 13 indicated that 88% of patients were being dealt with by A&E departments within four hours – short of the NHS Four Hour Standard Performance target of 95%.

Last winter, the Department of Health suffered damaging headlines relating to poor performance based on weekly figures. Data from the Office for National Statistics, published last week, revealed that death rates for last winter were the highest since 1999, with 44,000 more deaths above the seasonal average. The increase has been widely attributed to what has been described as an ‘ineffective’ flu vaccine.


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