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| NHS pressure worsens as key targets missed | NHS pressure worsens as key targets missed |
| (35 minutes later) | |
| The NHS is missing many of its key targets with more patients getting stuck in hospital, latest figures show. | The NHS is missing many of its key targets with more patients getting stuck in hospital, latest figures show. |
| Data from NHS England showed in September the health service missed its A&E target to see, treat or discharge patients within four hours. | Data from NHS England showed in September the health service missed its A&E target to see, treat or discharge patients within four hours. |
| Performance also fell short on access to cancer treatment, diagnostic tests and ambulance response times. | Performance also fell short on access to cancer treatment, diagnostic tests and ambulance response times. |
| To make matters worse, hospitals have been struggling to get patients out when they are ready to leave. | To make matters worse, hospitals have been struggling to get patients out when they are ready to leave. |
| A snapshot taken on the last Thursday of September showed more than 5,000 patients in England were occupying beds, even though they could have been discharged. | A snapshot taken on the last Thursday of September showed more than 5,000 patients in England were occupying beds, even though they could have been discharged. |
| Industrial action | Industrial action |
| This was the worst level since records began in 2010 - with the rise in delays over the past few months largely driven by problems accessing social care services, such as help in the home. | This was the worst level since records began in 2010 - with the rise in delays over the past few months largely driven by problems accessing social care services, such as help in the home. |
| Elsewhere in the UK, the NHS has been struggling as well with the four-hour A&E targets being missed everywhere. Scotland is performing the best. | Elsewhere in the UK, the NHS has been struggling as well with the four-hour A&E targets being missed everywhere. Scotland is performing the best. |
| Analysis: How bad is it looking? | Analysis: How bad is it looking? |
| On almost every measure, the NHS in England is in a worse position than this time last year. | On almost every measure, the NHS in England is in a worse position than this time last year. |
| And as we enter winter, that spells bad news: last year's was the worst for a generation with A&E waits hitting their highest levels since targets were introduced in 2004. | And as we enter winter, that spells bad news: last year's was the worst for a generation with A&E waits hitting their highest levels since targets were introduced in 2004. |
| But the pressures are now spreading more to other parts of the system. Once in hospital, doctors are finding it difficult to discharge patients because the support services in the community needed for the most vulnerable are not available. | But the pressures are now spreading more to other parts of the system. Once in hospital, doctors are finding it difficult to discharge patients because the support services in the community needed for the most vulnerable are not available. |
| Waits for diagnostic tests are lengthening and the key cancer target has been missed for well over a year. | Waits for diagnostic tests are lengthening and the key cancer target has been missed for well over a year. |
| Even on routine treatment - hips and knees - the signs are not good. The target is being met, but on the current trajectory it will be missed by the end of the year. The weather may be mild, but winter has come early for the NHS. | Even on routine treatment - hips and knees - the signs are not good. The target is being met, but on the current trajectory it will be missed by the end of the year. The weather may be mild, but winter has come early for the NHS. |
| Read more from Nick | Read more from Nick |
| Alarm as patients 'shun flu jab' | Alarm as patients 'shun flu jab' |
| NHS deficits hit a 'massive' £930m | NHS deficits hit a 'massive' £930m |
| The monthly data for England also showed: | The monthly data for England also showed: |
| However, there were some measures the NHS in England did meet. In total six of the eight cancer targets were achieved, while the 18-week target for patients to be seen for non-emergency operations such as knee and hip replacements was met. | However, there were some measures the NHS in England did meet. In total six of the eight cancer targets were achieved, while the 18-week target for patients to be seen for non-emergency operations such as knee and hip replacements was met. |
| The rising problems come as junior doctors are being balloted on industrial action over a dispute with government about their new contract. | The rising problems come as junior doctors are being balloted on industrial action over a dispute with government about their new contract. |
| The result of that vote is expected next week and could lead to 35,000 junior doctors walking out as winter hits. | The result of that vote is expected next week and could lead to 35,000 junior doctors walking out as winter hits. |
| The NHS is also under pressure to save money with figures for the first three months of this financial year showing overspending has hit nearly £1bn - more than the total for the whole of the previous year. | The NHS is also under pressure to save money with figures for the first three months of this financial year showing overspending has hit nearly £1bn - more than the total for the whole of the previous year. |
| Dr Mark Holland, the president of the Society for Acute Medicine, said this was creating the "perfect storm". | Dr Mark Holland, the president of the Society for Acute Medicine, said this was creating the "perfect storm". |
| He added: "There is already talk of putting ambulances on divert, of taking patients to other hospitals. | He added: "There is already talk of putting ambulances on divert, of taking patients to other hospitals. |
| "That intensity is beginning to creep up. Not on a day-to-day consistent basis like last December and January, but it's starting and it feels like it is occurring a wee bit too early. | "That intensity is beginning to creep up. Not on a day-to-day consistent basis like last December and January, but it's starting and it feels like it is occurring a wee bit too early. |
| "The question this winter is how resilient we will be and what will be the tipping point. And that is the unknown factor which is very, very worrying." | "The question this winter is how resilient we will be and what will be the tipping point. And that is the unknown factor which is very, very worrying." |
| Shadow health secretary Heidi Alexander said it looks like it will be the "most difficult winter for 30 years". | Shadow health secretary Heidi Alexander said it looks like it will be the "most difficult winter for 30 years". |
| She added: "There is now clear evidence that the cuts to social care are not only devastating for the lives of vulnerable older people, but are having a knock-on effect on the NHS." | She added: "There is now clear evidence that the cuts to social care are not only devastating for the lives of vulnerable older people, but are having a knock-on effect on the NHS." |
| An NHS England spokeswoman said the health service was coping well given the context as it was seeing a "record number" of patients. | An NHS England spokeswoman said the health service was coping well given the context as it was seeing a "record number" of patients. |
| "Nobody could argue there isn't ongoing pressure on the NHS but despite this, it is delivering a good service for the vast majority of patients," she added. | "Nobody could argue there isn't ongoing pressure on the NHS but despite this, it is delivering a good service for the vast majority of patients," she added. |
| Meanwhile, the British Medical Association has released details of the days industrial action could take place. The union said it wanted to give as much notice as possible to avoid disruption for patients. | |
| The dates and times are: | |
| •8am Tuesday 1 December to 8am Wednesday 2 December 2015 (covering emergency care) | |
| •8am to 5pm Tuesday 8 December 2015 (full walkout) | |
| •8am to 5pm Wednesday 16 December 2015 (full walkout) | |
| Action may take place on all three days or on just one or two of them. The details will be confirmed once the result of the ballot is known next week. | |
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