• Continued decline in A&E performance − a priority area for the health service
  • Ten trusts responsible for 20 per cent of target breaches
  • Emergency care improvement programme team to be sent into a further 12 areas

Ten hospital trusts clocked up 20 per cent of all accident and emergency breaches in May, HSJ analysis of the most recent official data reveals (see table).

The trusts, all but one of which are in the Midlands or London, saw 12 per cent of the 2m people who attended A&E in May, but were responsible for more than a fifth of the 201,000 breaches of the national target, for 95 per cent of patients to be admitted or discharged within four hours.

 Trust

Total attendances

Total four hour breaches

England total

2,061,609

201,226

Barts Health Trust

41,063

5,449

Barking, Havering and Redbridge University Hospitals Trust

24,143

4,499

University Hospitals of North Midlands Trust

21,520

4,464

Nottingham University Hospitals Trust

17,386

4,346

University Hospitals of Leicester Trust

20,983

4,227

North Middlesex University Hospital Trust

14,979

4,059

King’s College Hospital Foundation Trust

25,568

3,819

Pennine Acute Hospitals Trust

28,245

3,818

London North West Healthcare Trust

28,568

3,423

Lewisham and Greenwich Trust

23,890

3,273

Although most of the lowest performing trusts are large, North Middlesex University Hospital Trust is an exception. The trust saw almost half as many attendances as London North West Healthcare Trust, for example, but contributed more breaches to the national total.

The top 20 trusts were jointly responsible for a third of the total breachers.

National performance against the four hour measure fell to 90.2 per cent in May, down from 94.3 per cent last May.

For the 2016-17 year to date, the total was was 90.1 per cent, compared to 93.8 per cent last year.

Just 13 trusts hit the target in May.

NHS Improvement chief executive Jim Mackey this week confirmed that improving A&E performance was a priority for the regulator.

NHS England’s data also showed emergency admissions for May were more than 5 per cent higher than in May last year.

The Nuffield Trust said the A&E performance figures were worrying. Chief executive Nigel Edwards said: “By this time of year, the health service would normally expect to see a reduction in the pressure it suffers during winter and spring. But the fact that the proportion of people being moved through A&E within four hours was still a long way below the 95 per cent target in May shows that the traditional summer respite for the NHS is now becoming a thing of the past, as our research revealed in February.”

Jim Mackey: 'The NHS is in a mess'