More NHS foundation hospitals miss A&E waiting time targets: 32 out of 88 hospital trusts failing to treat accident patients within four hours of arrival. Sharply rising numbers of hospitals are failing to treat patients arriving in accident and emergency units within four hours – one of the government's key targets for the NHS – amid concern that hospitals cannot cope with growing demand.
In all, 32 foundation trust hospitals, out of 88 acute trusts with A&E units in England, missed the target in the last three months of 2012. This was double the number recorded in the same period the year before; it was also a fourfold increase on the eight hospitals who did not meet the target in the previous quarter of 2012.
The 32 trusts failed to treat the required 95% of emergency patients within four hours of their arrival. Until 2010, hospitals were obliged to treat 98% of patients in that time, but the coalition relaxed this to 95%.
The latest figures from Monitor, which regulates semi-independent NHS foundation trusts, are the latest evidence to emerge that hospitals are struggling to deal with ever-increasing numbers of patients turning up in A&E.
Monitor blames the rise on the winter vomiting bug norovirus, delays in discharging patients because community-based health services are inadequate, and the fact that increasing numbers of older people need care.
Stephen Hay, Monitor's managing director of provider regulation, said it was concerned about the "significant increase" in hospitals failing to meet targets. But he stressed that while demand for A&E services was growing across the NHS, "it is not acceptable that patients have to wait longer". Hospitals needed to work closely with other health services to reduce the growing pressure on A&E, he said. The situation was likely to be worse in the current quarter to the end of March, he added.
The organisation that represents foundation trusts said some trusts were seeing the biggest pressure on A&E for 10 years and complained that its members were being penalised financially because they were not being paid the full cost of treating A&E patients. "NHS trusts are doing all they can to ensure that no patient waits in A&E longer than is necessary. But trusts are being hit by a double whammy of rising demand and only getting 30% of the cost of treating this extra emergency demand, particularly over the recent winter months. The latest data – which is the worst in a decade in some places – shows that we need an urgent debate on whether the current approach to A&E is sustainable clinically or financially," said Chris Hopson, chief executive of the Foundation Trust Network.
The Department of Health did not comment directly on Monitor's findings. Instead, it stressed that hospitals should ensure emergency patients did not have to wait too long to be seen, despite rising pressure. "Patients need to be able to rely on prompt, high-quality, urgent and emergency care and treatment. We are clear that patients shouldn't face excessive waits for treatment," said a spokesman. "Where there is extra demand on services, hospitals and staff need to work together to ensure patients get the care they need."
Dr Peter Carter, chief executive of the Royal College of Nursing, said: "This report is an unsettling but unsurprising insight into a system which is struggling to cope with fewer resources and rising demand, and it is patients who are suffering as a result. We know from our own research and from our members that the system is running at capacity, and cannot handle any extra demand such as winter viruses. It is unacceptable for patients to have to wait so long during an already difficult time.
"This is also evidence of a system which is fragmented and failing to work together. The report mentions the delays caused by problems accessing community care services and this shows the knock-on effects that cuts to community services can have on the rest of the system. District nursing staff work to keep people out of hospitals in the first place, and cutting staff in this area is real short-term thinking. You cannot take resources away from acute care if the community services are not there to take up the slack."
In December, a survey by the Care Quality Commission, which regulates NHS care standards, showed that 33% of people spent more than four hours waiting for treatment in A&E, up from 27% in 2008. It also noted a large rise in the number of patients who had to wait more than 30 minutes before seeing a nurse or doctor.
Last month a report on NHS performance by health thinktank the King's Fund said that the proportion of patients waiting longer than four hours in A&E departments in the last quarter of 2012 had reached its highest level for that time of year since 2003-04, with 25% missing the target.
It also highlighted "a possible emerging upward trend, beginning in the middle of 2009-10, in the proportion of patients waiting more than four hours to be admitted to hospital via A&E – so-called 'trolley waits'. In the latest quarter, 'trolley waits' were at their highest rate since the same period in 2003-04," it said. The Guardian
In all, 32 foundation trust hospitals, out of 88 acute trusts with A&E units in England, missed the target in the last three months of 2012. This was double the number recorded in the same period the year before; it was also a fourfold increase on the eight hospitals who did not meet the target in the previous quarter of 2012.
The 32 trusts failed to treat the required 95% of emergency patients within four hours of their arrival. Until 2010, hospitals were obliged to treat 98% of patients in that time, but the coalition relaxed this to 95%.
The latest figures from Monitor, which regulates semi-independent NHS foundation trusts, are the latest evidence to emerge that hospitals are struggling to deal with ever-increasing numbers of patients turning up in A&E.
Monitor blames the rise on the winter vomiting bug norovirus, delays in discharging patients because community-based health services are inadequate, and the fact that increasing numbers of older people need care.
Stephen Hay, Monitor's managing director of provider regulation, said it was concerned about the "significant increase" in hospitals failing to meet targets. But he stressed that while demand for A&E services was growing across the NHS, "it is not acceptable that patients have to wait longer". Hospitals needed to work closely with other health services to reduce the growing pressure on A&E, he said. The situation was likely to be worse in the current quarter to the end of March, he added.
The organisation that represents foundation trusts said some trusts were seeing the biggest pressure on A&E for 10 years and complained that its members were being penalised financially because they were not being paid the full cost of treating A&E patients. "NHS trusts are doing all they can to ensure that no patient waits in A&E longer than is necessary. But trusts are being hit by a double whammy of rising demand and only getting 30% of the cost of treating this extra emergency demand, particularly over the recent winter months. The latest data – which is the worst in a decade in some places – shows that we need an urgent debate on whether the current approach to A&E is sustainable clinically or financially," said Chris Hopson, chief executive of the Foundation Trust Network.
The Department of Health did not comment directly on Monitor's findings. Instead, it stressed that hospitals should ensure emergency patients did not have to wait too long to be seen, despite rising pressure. "Patients need to be able to rely on prompt, high-quality, urgent and emergency care and treatment. We are clear that patients shouldn't face excessive waits for treatment," said a spokesman. "Where there is extra demand on services, hospitals and staff need to work together to ensure patients get the care they need."
Dr Peter Carter, chief executive of the Royal College of Nursing, said: "This report is an unsettling but unsurprising insight into a system which is struggling to cope with fewer resources and rising demand, and it is patients who are suffering as a result. We know from our own research and from our members that the system is running at capacity, and cannot handle any extra demand such as winter viruses. It is unacceptable for patients to have to wait so long during an already difficult time.
"This is also evidence of a system which is fragmented and failing to work together. The report mentions the delays caused by problems accessing community care services and this shows the knock-on effects that cuts to community services can have on the rest of the system. District nursing staff work to keep people out of hospitals in the first place, and cutting staff in this area is real short-term thinking. You cannot take resources away from acute care if the community services are not there to take up the slack."
In December, a survey by the Care Quality Commission, which regulates NHS care standards, showed that 33% of people spent more than four hours waiting for treatment in A&E, up from 27% in 2008. It also noted a large rise in the number of patients who had to wait more than 30 minutes before seeing a nurse or doctor.
Last month a report on NHS performance by health thinktank the King's Fund said that the proportion of patients waiting longer than four hours in A&E departments in the last quarter of 2012 had reached its highest level for that time of year since 2003-04, with 25% missing the target.
It also highlighted "a possible emerging upward trend, beginning in the middle of 2009-10, in the proportion of patients waiting more than four hours to be admitted to hospital via A&E – so-called 'trolley waits'. In the latest quarter, 'trolley waits' were at their highest rate since the same period in 2003-04," it said. The Guardian
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