Only three trusts hit new A&E target

New figures today also reveal that the national mean response for category one calls – the most serious, including cardiac arrests, respiratory arrest and traumatic bleeding – increased sharply, breaching 10 minutes for the first time against an eight-minute target. 

Thus far category one response times have been relatively protected from the performance crash of the past 18 months, but in December the national average rose to 10 minutes and 57 seconds. One in 10 of these most serious calls took more than 19m 25s to reach, according to the NHS England data.

It coincided with a steep increase, of nearly a fifth month-on-month, in the number of category one incidents, to a record 101,099. In December 2019 – pre-pandemic – there were 70,459.

The UK has seen a large wave of flu infections this winter, appearently peaking around Christmas; along with ongoing pressures including overfull hospitals; ambulance handover delays at accident and emergency, covid, staff absences and social care delays. 

Category two

There was also another steep increase in category two response times, which cover other serious calls including suspected strokes and heart attacks, reaching an average of 1h 32m 54s – by far the worst on record. One in 10 patients waited more than 3h 41m 48s.

Previously, no single ambulance trust had breached a two hours mean category two response. But in December, the South West, East Midlands and East of England all exceeded it (see chart left). In South West the average was 2h 39m 12s, with one in 10 waiting more than 6h 39m 34s. Neither the number of category two incidents, nor the total number of incidents responded to, was particularly high.

These regions have seen many long ambulance handover delays, which have been the biggest cause of longer responses as they tie up crews waiting outside A&Es.

Call-answering delays

However, the number of calls answered was the highest on record, probably reflecting patients and relatives calling back to see when an ambulance would arrive. Those calls also took longer to answer, with an average time of 1m 28s and one in 10 taking more than 3m 50s – again, record times. Callers to South East Coast Ambulance Service Foundation Trust had to wait 175s on average to have their call answered.

In December 2019, nationally calls took an average of eight seconds to answer and the 90^th percentile performance was 21 seconds.

However, there are signs of hope in weekly winter performance “sits rep” data. Hours lost to ambulance handover delays, and the number of delays of more than an hour, dropped sharply in the week to 8 January, compared to record highs in the previous few weeks. And yesterday’s strike seems to have passed off largely without incident, with several areas reporting demand from the public was subdued. 

Sharp rise in 12-hour waits

A new record number of patients waiting 12 hours in A&E from a decision to admit was recorded in December after a steep rise from the month before (see chart left)

A total 54,532 A&E patients waited 12 hours or more from a decision to admit in December, up from 37,837 in November, and the previous record high of 43,792 waits in October last year. It was also more than four times higher than the 12,859 12 hour DTA waits recorded in December 2021.

Three trusts meet new target

For the first time ever, fewer than half of patients at type one A&E departments – 49.6 per cent – were admitted, transferred or discharged in December. At two trusts – Barking, Havering and Redbridge University Hospitals Trust and Torbay and South Devon Foundation Trust – this was less than 30 per cent.

Just three acute trusts admitted, transferred or discharged 76 per cent or more of all types of emergency patients – in line with an NHS England target for March 2024. These were Northumbria Healthcare FT, Blackpool Teaching FT and Maidstone and Tunbridge Wells Trust.

Elective care

On elective care, today’s data – covering November – showed an apparent improvement in performance, with the overall list, and numbers of very long waiters, slightly down.