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| NHS 'misses A&E waiting time target' | NHS 'misses A&E waiting time target' |
| (35 minutes later) | |
| The NHS in England missed its A&E waiting time target in the first three months of the year, researchers say. | The NHS in England missed its A&E waiting time target in the first three months of the year, researchers say. |
| A total of 313,000 patients waited more than four hours, up 39% on the similar period in 2012, the King's Fund said after analysing official statistics. | A total of 313,000 patients waited more than four hours, up 39% on the similar period in 2012, the King's Fund said after analysing official statistics. |
| That represented 5.9% of patients when the NHS is allowed a leeway of 5%. | That represented 5.9% of patients when the NHS is allowed a leeway of 5%. |
| A&E waits are now at their worst level for nine years, but the government said extra money was being made available to help the worst-hit hospitals. | A&E waits are now at their worst level for nine years, but the government said extra money was being made available to help the worst-hit hospitals. |
| However, evidence is also emerging that hospital performance in areas such as infection control and cancer care could be deteriorating. | |
| The news points to what many experts have been warning about. | The news points to what many experts have been warning about. |
| Last month both doctors and managers claimed the system was heading for a crisis as hospitals were struggling to cope with rising demand amid pressures on funding and staffing levels. | Last month both doctors and managers claimed the system was heading for a crisis as hospitals were struggling to cope with rising demand amid pressures on funding and staffing levels. |
| 'Car parks' | 'Car parks' |
| There have been reports of temporary waiting areas being set up in car parks and store rooms to help some units manage demand. | There have been reports of temporary waiting areas being set up in car parks and store rooms to help some units manage demand. |
| The King's Fund used official government statistics to get the full picture for January, February and March - the final quarter of the year 2012-13. | The King's Fund used official government statistics to get the full picture for January, February and March - the final quarter of the year 2012-13. |
| Patients should be seen, diagnosed and treated within four hours, but the analysis showed 5.9% had waited longer than that, although the figures since then show improvement, the think tank said. | Patients should be seen, diagnosed and treated within four hours, but the analysis showed 5.9% had waited longer than that, although the figures since then show improvement, the think tank said. |
| In a review it published earlier this year, it found that from October to December 2012 more than 232,000 A&E patients had waited more than four hours. | In a review it published earlier this year, it found that from October to December 2012 more than 232,000 A&E patients had waited more than four hours. |
| That was a rise of 21% compared with the similar period in 2011 but, at 4.3% of patients, still within the government's target. | That was a rise of 21% compared with the similar period in 2011 but, at 4.3% of patients, still within the government's target. |
| A&E units have to see only 95% of patients within four hours, to reflect the fact that some flexibility is needed to allow doctors to prioritise the patients with the greatest need. | A&E units have to see only 95% of patients within four hours, to reflect the fact that some flexibility is needed to allow doctors to prioritise the patients with the greatest need. |
| John Appleby, chief economist at the King's Fund, told the BBC there was no single explanation for the "spike" in waits, but an ongoing squeeze on the NHS budget was "one of the key reasons". | John Appleby, chief economist at the King's Fund, told the BBC there was no single explanation for the "spike" in waits, but an ongoing squeeze on the NHS budget was "one of the key reasons". |
| While the government has ring-fenced the budget from cuts, the NHS is expected to find efficiencies of £20bn by 2014. | While the government has ring-fenced the budget from cuts, the NHS is expected to find efficiencies of £20bn by 2014. |
| "The other thing to remember is that these emergency departments are not working in isolation - they work with other parts of the hospital," Mr Appleby added. | "The other thing to remember is that these emergency departments are not working in isolation - they work with other parts of the hospital," Mr Appleby added. |
| "If you haven't got the beds for people flowing through then you very quickly back up into A&E." | "If you haven't got the beds for people flowing through then you very quickly back up into A&E." |
| 'Disastrous legacy' | 'Disastrous legacy' |
| Meanwhile, a separate analysis by Monitor, which regulates the elite foundation trusts accounting for two-thirds of NHS services, found evidence that performance in areas such as cancer care, non-emergency operations and infection control could be deteriorating because of the growing pressures. | Meanwhile, a separate analysis by Monitor, which regulates the elite foundation trusts accounting for two-thirds of NHS services, found evidence that performance in areas such as cancer care, non-emergency operations and infection control could be deteriorating because of the growing pressures. |
| Sir Richard Thompson, president of the Royal College of Physicians, said: "This is no surprise - patients are presenting at emergency departments in increasing numbers because there is nowhere else they can go. | Sir Richard Thompson, president of the Royal College of Physicians, said: "This is no surprise - patients are presenting at emergency departments in increasing numbers because there is nowhere else they can go. |
| "Patients arriving at the 'front door' of the hospital have an impact on acute services throughout the hospital, and we need to redesign emergency care systems around the patient, while making sure that clinicians' workloads and working practices are safe and sustainable." | "Patients arriving at the 'front door' of the hospital have an impact on acute services throughout the hospital, and we need to redesign emergency care systems around the patient, while making sure that clinicians' workloads and working practices are safe and sustainable." |
| British Medical Association chairman Dr Mark Porter added: "Unfortunately, the evidence suggests that the problem will get worse before it gets better." | British Medical Association chairman Dr Mark Porter added: "Unfortunately, the evidence suggests that the problem will get worse before it gets better." |
| A spokesman for Health Secretary Jeremy Hunt said plans were in place to deal with the pressures with extra money being made available to help the worst-hit hospitals cope. | A spokesman for Health Secretary Jeremy Hunt said plans were in place to deal with the pressures with extra money being made available to help the worst-hit hospitals cope. |
| He said the problems were part of a "disastrous" legacy from Labour. | He said the problems were part of a "disastrous" legacy from Labour. |
| But shadow health secretary Andy Burnham said: "The crisis in A&E proves that you can't trust David Cameron with the NHS." | But shadow health secretary Andy Burnham said: "The crisis in A&E proves that you can't trust David Cameron with the NHS." |