Thirty trusts report more 12-hour waits, despite national improvement

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One in five trusts delivering worse 12-hour waits, despite improving national trend
NHSE warned four hours target is diverting attention from most vulnerable patients
Waits for admission and rising demand for inpatient mental health services among key factors

Long A&E waits have got worse at more than one in five acute trusts, despite an improving trend nationally.

Around 30 acute trusts have reported an increase in long accident and emergency waits, bucking the national trend.

According to data covering the nine months to December, the proportion of waits more than 12 hours from time of arrival has improved to 6.3 per cent, down from 8 per cent during the same period in 2022.

However, 28 out of 119 acute trusts reported a rise of up to 3 percentage points.

HSJ’s analysis, which used published and unpublished data, showed 11 of these trusts had worsened despite improving their headline performance against the four-hour target.

Last month HSJ reported that trusts were being pressured to prioritise efforts on non-admitted emergency patients, who tend to have less serious problems. This was thought to be part of a bid to meet the four-hour target, which is under significant scrutiny from government.

Health data analyst Steve Black suggested that if trusts are achieving a better four-hour performance – but reporting more 12-hour waits – this is a sign they have “missed the point” and this amounted to “rearranging the deckchairs instead of steering away from the iceberg”.

Adrian Boyle, of the Royal College of Emergency Medicine, said the emphasis on the four-hour target “incentivises focus on the people who are being sent home, and takes effort and attention away from the people who are being admitted to hospital”.

He added: “The harms of long waits are greatest for people being admitted to hospital. We are disappointed by the current lack of focus in the planning guidance to help our most vulnerable patients.”

Trusts told HSJ that 12-hour waits have increased due to waits for ward beds, rises in A&E attendances and challenges in finding inpatient mental health beds, rather than any “disproportionate” focus on four hours.

There have been a record 19.5 million attendances at all types of urgent care facility between April and December. The proportion dealt with within four hours was 72 per cent – up two percentage points on last year.

NHS England said it “will continue to work with the most challenged trusts and colleagues in local authorities to focus on speeding up discharge, boosting patient flow and freeing up beds for those who need them most”.

Trusts with worsening 12-hour waits

	Proportion of attendances >12hrs	12-hr % point increase	4hr improvement?
England	6.3%	-1.5	Yes

The Shrewsbury and Telford Hospital Trust	17.3%	3.3	Same
Isle of Wight Trust	10.7%	3.2	No
George Eliot Hospital Trust	8.3%	3.1	No
Wrightington, Wigan and Leigh FT	11.0%	2.1	No
Airedale FT	4.6%	1.9	Yes
Epsom and St Helier UHT*	13.3%	1.9	Yes
Kettering General Hospital FT	9.6%	1.8	Figures unavailable
Ashford and St Peter’s Hospitals FT	8.4%	1.7	Same
Wirral University Teaching Hospital FT	11.3%	1.7	No
Countess of Chester Hospital FT	17.4%	1.7	No
Calderdale and Huddersfield FT	3.8%	1.5	No
The Dudley Group FT	6.5%	1.1	No
North Middlesex UHT	7.7%	1.0	Yes
Mid Yorkshire Teaching Trust	5.7%	0.9	Figures unavailable
London North West UHT	7.0%	0.6	Yes
Sandwell and West Birmingham Hospitals Trust	4.8%	0.6	No
UH Birmingham FT	14.4%	0.6	Yes
Royal Berkshire FT	1.3%	0.5	Yes
The Newcastle Upon Tyne Hospitals FT	1.6%	0.5	No
Blackpool Teaching Hospitals FT	8.2%	0.4	Same
Milton Keynes University Hospital FT	4.0%	0.4	No
Northumbria Healthcare FT	0.2%	0.2	Same
Worcestershire Acute Hospitals Trust	10.2%	0.1	No
University College London Hospitals FT	2.3%	<0.1	Yes
East Suffolk and North Essex FT	4.3%	<0.1	Yes
Hampshire Hospitals FT	4.2%	<0.1	Yes
The Hillingdon Hospitals FT	5.4%	<0.1	Yes
Walsall Healthcare Trust	3.1%	<0.1	Yes