The number of patients waiting more than 12 hours for a bed on a ward after being seen in A&E in England was 19 times higher this winter than it was before the pandemic, figures show. There were nearly 100,000 12-hour waits in December and January – compared with slightly more than 5,000 in 2019-20. A decade ago these waits were virtually unheard of – in the four winters up to 2013-14 there were fewer than 100.
The King’s Fund said long delays were at risk of becoming normalised and that the pressures this winter had received little attention compared with last winter, despite no significant improvement in performance.
Record-level A&E Waiting Times
The King’s Fund has stated that A&E performance continues to decline and that the standard for type 1 A&E performance has been missed since July 2013. The current A&E standard was introduced in 2010 and states that 95 per cent of patients arriving at an A&E department should be admitted to hospital, transferred to a more appropriate care setting, or discharged home within four hours.
In December 2022, performance across all A&E types was its lowest ever and less than half of all attendances at type 1 departments were seen within four hours. In addition, more people are leaving A&E before they’ve been seen by a clinician, with 6 per cent of all people who attended A&E in November 2022 leaving before being seen, up from 2.2 per cent in November 2019.
Waits for emergency admissions have also increased to record levels as resources to treat A&E patients have not kept pace with rising demand. while the NHS has been admitting more patients through A&E, the number of general and acute overnight beds available in Q2 2022/23 was 5.7 per cent less than in Q2 2011/12, and the percentage of them that were occupied has risen from 85.6 per cent to 90 per cent. The NHS is also facing a workforce crisis with more than 133,000 posts currently vacant, impacting trusts’ ability to admit patients from A&E in a timely fashion.
During December 2023 and January 2024, 98,300 patients waited more than 12 hours for a bed on a ward after A&E doctors took the decision to admit them. These tend to be the sickest and frailest patient – and this wait comes after they have already waited to be seen in the first place after arriving at A&E.
Delays waiting to be seen in A&E are also much worse than they were before the pandemic – more than 30% of patients have waited at least four hours over the past two months.
Urgent calls for NHS reform
NHS data published last year revealed a distressing reality within the NHS, as waiting lists reach unprecedented lengths, leaving a staggering 85% of patients anxiously awaiting crucial decisions regarding their medical care.
These alarming figures shed light on the challenges faced by England’s healthcare system and have ignited a fervent call for comprehensive reforms. As the NHS grapples with mounting pressures, the question that looms is not just about increasing theatre capacity, but rather the imperative need for enhanced diagnostic capabilities and streamlined decision-making processes.
Curia’s NHS Innovation and Life Sciences Commission
Independent, cross-party, and not-for-profit, as a policy institute Curia turns policy into practice as the UK’s first “do tank”.
Jointly chaired by former Life Sciences and Innovation Minister, Lord James O’Shaughnessy and former Deputy Medical Director at NHS England Professor Mike Bewick, the NHS Innovation and Life Sciences Commission seeks to identify examples of good practice in innovation, draw learning and consider how implementation plans across the sector can improve the lives of patients. By bringing together key strands of policy and developing effective implementation strategies through extensive research, the Commission seeks to see change at every level within the NHS.