A&E performance falls for ninth successive year

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Performance against four-hour benchmark hits new annual low in 2018-19
Demand reaches record high with 380,000 more admissions than previous year
Maintaining care quality in face of ever rising demand “becoming untenable”

The NHS’ capacity crisis was laid bare by official data published today, which confirmed 2018-19 was the worst year on record for breaches of the four-hour waiting time target.

Performance against the flagship accident and emergency target has now deteriorated for nine successive financial years – every year since 2010-11.

NHS England reported 88 per cent of patients were seen within four hours against the 95 per cent target in 2018-19 – the worst performance since the standard was introduced, originally with a 98 per cent, target 15 years ago.

The data comes as NHSE is set to start trials of four new A&E metrics at 14 trusts next month – a process which could see the four-hour target scrapped altogether.

Performance in 2017-18 was 88.3 per cent across all types of A&Es, and 89.1 per cent in 2016-17. It also followed a chastising winter in which performance hit a record monthly low in February of 84.2 per cent.

A&E performance to 2018-19
Infogram

The downward trend continued as demand rose to hit a record high. This winter, more than 380,000 additional patients were treated within four hours in NHS A&Es compared with last year, according to NHSE. The national commissioner praised staff for their hard work as attendances reached more than seven million.

Performance did, however, recover in March to 86.6 per cent, which was two percentage points better than March 2018.

Overall performance also improved when comparing the last quarter of 2018-19, December to March, with the same period last winter – up from 85 to 85.4 per cent. This is the first time in five years there has not been a year-on-year fall when comparing the quarter four data.

Health Foundation senior policy fellow Tim Gardner said: “The record number of people treated within the four-hour target over the last 12 months is testament to the huge efforts of NHS staff. However, growing numbers of people are waiting over four hours as demand continues to outstrip provision.

It is becoming untenable for the NHS to maintain quality of care in the face of ever rising demand from patients with increasingly complex conditions, ongoing funding issues and growing staff shortages.”

The think tank also said whatever the result of the new A&E metrics trial, it was “vital that comparable data remains publicly available to maintain a consistent, long-term view of how the NHS is performing in the face of these pressures”.

NHS national director of emergency and elective care Pauline Philip said: “Throughout the NHS, staff have worked tirelessly to deliver the improvements we’ve seen for patients this winter, putting in place new and improved services, delivering a record number of flu jabs and providing care directly to a record number of people.”

Meanwhile, figures show 70.3 per cent of staff took up the flu jab at work, compared to 68.7 per cent last winter.