12-hour A&E waits soar to new record as waiting list hits 7m

There was however some encouraging news, with the growth in admissions of covid positive inpatients slowing dramatically. This suggests the current wave may be coming to an end sooner than expected (See box: Dramatic slowdown in covid admissions growth).

12-hour A&E waits continue to spiral

The monthly data laid bare the rising pressure on emergency departments, with the number of patients waiting more than 12 hours in A&E from a decision to admit jumping from 28,756 in August to a new record of 32,776 in September.

This represents a significant month-on-month increase and the figure is also more than six times the 5,024 long waits recorded in September 2021.

A record low proportion of patients in type 1 A&Es, 56.9 per cent, waited four hours or less for admission, transfer or discharge in September.

This was a slight drop from the 58 per cent recorded in August. It continues what has largely been deterioration of the four-hour standard since the 80 per cent recorded in March 2021.

The deteriorating performance in emergency care has occurred despite attendances to A&Es dropping year-on-year, with high occupancy and delayed discharge issues at many hospitals a key factor.

The number of people attending type 1 A&E departments in September was 6.5 per cent lower than the same month in 2021, and 3 per cent lower than in September 2019.

Manchester University Hospitals Foundation Trust recorded the second worst four-hour performance at type 1 A&Es, with just 36.3 per cent of patients being seen in that time. This marks a striking monthly deterioration from the 49.6 per cent the trust recorded in August – when it had 400 more attendances. Barking, Havering and Redbridge University Hospitals Trust again had the worst four hours performance in the country in September, with 31.8 per cent of patients being seen within the target.

Elective long waiter reduction progress slows as list grows

The growth in the overall referral to treatment list and the number of 52-week plus waiters continued in August — the latest month covered by today’s elective data — while progress in cutting both 78-week and 104-week breaches slowed.

There were 7 million people on the waiting list in August, up from 6.8 million in July while the number of year-plus breaches increased from around 378,000 to 388,000.

Meanwhile, the month-on-month reduction in 18-month waiters – the NHS’s next elective target is to eliminate this cohort by March – slowed. There were 50,888 78-week breaches as of August, 950 fewer than the 51,838 in July.

The drop of 950 is under half as many as the 2,073 drop between June and July and around six times smaller than 5,851 drop between May and June.

NHSE pointed out substantial progress had been made on cutting the number of patients waiting for more than a year-and-a-half.

It said: “The number of people waiting 18 months for treatment continues to fall and was almost 60 per cent lower in August compared to the same month last year (121,711) and down by more than a quarter since the NHS launched the elective recovery plan in February (68,493).”

NHSE leaders are privately concerned that the elective recovery plan target to eliminate 78-week waiters by March will be missed because there is a “huge cohort” of more than a million patients who, if not treated, will tip into the 78-week plus category, as revealed by HSJ back in July.

The progress on cutting 104-week waiters also slowed. There were 2,646 two-year breaches on the list as of August, down from 2,885. The month-on-month reduction of 239 compares to reductions of 976 between June and July and over 4,000 between May and June.

Meanwhile, the cancer backlog continued to grow. The number of patients waiting longer than 62 days reached 32,614 in August, only slightly lower than the peak of 34,050 in May 2020.

The two-month wait following an urgent GP referral target was a performance of 61.9 per cent, against the target of 85 per cent, the fourth lowest ever, but a slight improvement from the previous three months.

The number of incidents dealt with by ambulance services in September was one of the lowest since the current system of measuring was fully introduced – but response times crept up slightly compared to August.

Average response times for the most serious category 1 calls increased from 9 minutes 8 seconds in August to 9m 19s in September and those for category 2 calls from 42m 44s to 47m 59s.

The target for category 1, which includes cardiac arrests, is seven minutes and for category 2, which includes potential strokes and heart attacks, 18 minutes.