Wes Streeting, Labour Shadow Health Secretary, said the latest figures show the “terrifying truth is that patients in an emergency can no longer be sure the NHS will be there for them”, while the Royal College of Emergency Medicine (RCEM) warned England’s NHS has “no more time for inaction and unfulfilled promises”.
Analysis of NHS England data by NationalWorld shows one in seven patients (14%) admitted to hospital through A&E in December endured waits of over 12 hours, or half a day, for a bed once medics decided they needed to be admitted. They could have been left languishing on trolleys or chairs in corridors while waiting for a bed or operating theatre to become free.
But at the East Cheshire NHS Trust, which runs the Macclesfield General Hospital, 60% of its 1,005 patients were left facing trolley waits of over 12 hours, over four times higher than the national rate. At four other trusts – all in London or the North West – more than 40% of patients waited over half a day, and at four more the figure was over a third. Countess of Chester Hospital Trust (50%) and North Middlesex University Hospital Trust (47%) were the next worst affected.
‘Intolerable, unsafe and unsustainable’
The figures include all those admitted after attending A&E, whether of their own accord or by ambulance. Not everybody who attends A&E needs to be admitted. .
RCEM president, Dr Adrian Boyle, described December’s emergency admission figures as “truly shocking” as he called on the government to show that it is hearing the pleas of the NHS, adding: “How far does emergency department performance need to fall for this to lead to meaningful action?”
Dr Den Langhor, emergency medicine lead for the British Medical Association (BMA), said the figures highlighted the enormous pressure emergency departments are under, describing the situation across many of the country’s A&Es as “intolerable, unsafe, and unsustainable”.
The number of patients left waiting 12 hours or longer across England was staggeringly high in December, with over 54,500 affected – a 44% rise on November, and a 324% rise on last December. Before September 2021, the figure had never exceeded 5,000. The graph below shows the proportion of patients that waited over 12 hours every month since 2010. Can’t see the graph? Click here to open it in a new window.
The RCEM argues the official figures “obfuscate the truth and are only the tip of the iceberg”, as they exclude many patients who waited over 12 hours from the point they arrived in hospital but not the point it was decided to admit them.
Research by the College found that in 2021, the number of patients who waited over 12 hours between arrival and admission was 14 times higher than the number that waited over 12 hours between decision to admit and admission – showing the existing data was a “gross underrepresentation of the reality of patient waits”.
No more ‘zero tolerance’
Until recently, NHS rules endorsed a “zero tolerance” stance on 12-hour waits, but in April this was relaxed, stating no more than 2% of patients should be affected. NHS England also agreed to begin measuring long waits from the point of arrival, but monthly figures are not yet being published publicly.
Further analysis reveals that while the proportion of patients facing extreme waits has spiralled across the country, the increase in the North, Midlands and London NHS regions has been even more pronounced than in the South East and South West.
NationalWorld approached the East Cheshire NHS Trust for comment. It directed us to a statement from NHS England North West, in which it described how staff were having to contend with the “ongoing challenge” posed by bed blocking, and urged family members of those well enough to leave hospital to help get them home as soon as possible and free up beds for urgent patients.
We also approached David Rutley, Conservative MP for Macclesfield, but had not received a response at the time of publishing.
Samantha Dixon, the new Labour MP for Chester, which is home to the second worst-hit trust, Countess of Chester, said: “The NHS is on its knees after more than a decade of Tory mismanagement. They promised investment and delivered chaos.
“In Chester the figures for the Countess are dissapointing but I know how hard clinical staff are working to keep caring for patients. I am looking forward to meeting with senior management and board members in the coming weeks to offer my support to them. The reality is that the Tories are to blame for this mess and we need a Labour government so we can get to work and sort it out.”
Elsewhere in the North West, Blackpool Teaching Hospitals Trust and Warrington and Halton Teaching Hospitals Trust were also badly affected – 43% and 38% of patients waited over 12 hours in December respectively.
The RCEM recently estimated that between 300 and 500 people were dying every week as a result of delays in emergency care – figures the government has disputed – while last week we revealed how northern and midlands regions were suffering particularly high levels of excess deaths over Christmas.
Labour Shadow Health Secretary Wes Streeting agrees that lives are being lost as a result of A&E delays. “Twenty-four hours in A&E is not just a TV programme, it is the grim reality for too many patients,” he said. “After 13 years of Conservative mismanagement of the NHS, expecting them to fix this crisis is like asking the arsonist to put out the fire they started - it is not going to happen.”
“A decade of underfunding, under-resourcing, and a failure to fulfil workforce pledges or commit to long-term workforce planning that tackled the retention crisis has led us to a broken system that does not perform its central function,” said the BMA’s Dr Boyle.
A spokesperson for the Department of Health and Social Care said the government is “fully committed to supporting our incredible NHS” and is making up to £14.1 billion available for health and social care over the next two years on top of record funding.
“We recognise the pressures the NHS is facing so announced up to £250 million of additional funding to immediately help reduce hospital bed occupancy, alleviate pressures on A&E and unlock much-needed ambulance handovers,” they said.
“This is on top of the £500 million Discharge Fund to speed up the safe discharge of patients and rolling out virtual wards to free up hospital beds and cut waiting times.”
Have you been affected by long waits at the East Cheshire NHS Trust or another hospital? Contact [email protected] to share your experience.
Update: This story has been updated to include a comment from Samantha Dixon, MP for City of Chester