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A&E performance in England 'likely to hit new low' A&E waiting in England worst for a decade
(about 1 hour later)
A&E waiting times in England have fallen to their worst level for a decade, figures out later are expected to show. The NHS in England has missed its four-hour A&E waiting time target with performance dropping to its lowest level for a decade, figures show.
The data being released by NHS England covers the October to December quarter. From October to December 92.6% of patients were seen in four hours - below the 95% target.
From the weekly statistics already available up to mid-December it is clear the four-hour target has almost certainly been missed. The performance is the worst quarterly result since the target was introduced at the end of 2004.
Performance is also on track to fall below the 94.1% mark recorded in the first three months of 2013. The rest of the UK is also missing the target and a number of hospitals have declared "major incidents" recently.
It comes amid growing pressures on hospitals with a number declaring "major incidents" in recent days because of A&E pressures. This signifies they are facing exceptional pressures and triggers extra staff being called in and other steps, including cancelling non-emergency care, such as routine operations.
It means extra staff are brought in to help them cope and other steps, including cancelling non-emergency care, such as routine operations, can be taken.
Health Secretary Jeremy Hunt admitted meeting the A&E standard was proving tough, but pointed out that England has some of the toughest targets in the world.Health Secretary Jeremy Hunt admitted meeting the A&E standard was proving tough, but pointed out that England has some of the toughest targets in the world.
"Targets matter but not at any cost. The priority is to treat people with dignity and respect.""Targets matter but not at any cost. The priority is to treat people with dignity and respect."
'Intolerable pressure''Intolerable pressure'
Dr Cliff Mann, of the College of Emergency Medicine, warned hospitals were reaching a "tipping point". It is the second time the target has been missed under the coalition. In the first three months of 2013 94.1% of patients were seen in four hours.
He said part of the reason was the NHS non-emergency line 111 advising an increasing proportion of people to seek emergency care. Meeting the target has proved particularly tough since the end of the summer. The target has been missed on a weekly basis - England provides these figures along with the quarterly statistics - every week except one since the end of August.
Dr Mann said: "My concern is the daily intolerable pressure is starting to have an effect on staff - they are more likely to become sick, become unable to work, burn out and choose to go into other professions. That means it is not a sustainable situation". Analysis: What is a major incident?
A&E units in England have struggled since the end of the summer. The target demands that A&E units see 95% of patients in four hours, but since the end of August it has only been met once, according to the weekly figures that are published. If a hospital declares a major incident or internal incident, it is a sign that things have got exceptionally busy and special measures are need to cope.
Overall, however, the NHS is judged on its performance over a quarter. This is what is being released on Tuesday. From the weekly data available from the start of October to the middle of December the current average for the quarter is running at just above 93%. This can happen in winter when demands are high, but also at other times, for example if there is a major road accident. The declaration allows hospital bosses to call in extra staff to help them cope. But it is also worth noting that some hospitals may not necessarily go public with their problems. You can be sure that there are more sites under intense pressure than the numbers officially on alert.
While that is below the target, it is still better than the performance being seen elsewhere in the UK. What is important is what steps they take in terms of restricting the flow of patients into the hospital. One of the first measures is to start postponing routine activity, such as knee and hip operations or outpatient appointments. This is not uncommon - and is likely to be happening at a significant number of sites at the moment.
England publishes weekly data and the others release it monthly or quarterly. More unusual is diverting ambulances so no emergency patients arrive. In effect, that closes the hospital. However, this is only used as a last resort as it increases demands on nearby sites.
However, the performance in England is still better than elsewhere in the UK. The data in the other nations lags a bit behind England.
In Wales the data from November shows just 83.8% of patients were seen in time.In Wales the data from November shows just 83.8% of patients were seen in time.
Northern Ireland is performing even worse - just over 80% of patients were seen within four hours in November.Northern Ireland is performing even worse - just over 80% of patients were seen within four hours in November.
Scotland has a slightly tougher waiting time target - 98% of patients should be seen in four hours - but in September 93.5% were.Scotland has a slightly tougher waiting time target - 98% of patients should be seen in four hours - but in September 93.5% were.
Comparing the September figures for England and Scotland shows England was performing slightly better in that month.Comparing the September figures for England and Scotland shows England was performing slightly better in that month.
'Cracks showing'
It means according to latest data all parts of the UK are missing the A&E waiting time target.It means according to latest data all parts of the UK are missing the A&E waiting time target.
Dr Cliff Mann, of the College of Emergency Medicine, warned hospitals were reaching a "tipping point".
He said part of the reason was the NHS non-emergency line 111 advising an increasing proportion of people to seek emergency care.
Dr Mann said: "My concern is the daily intolerable pressure is starting to have an effect on staff - they are more likely to become sick, become unable to work, burn out and choose to go into other professions. That means it is not a sustainable situation".
'Cracks showing'
Nigel Edwards, chief executive of the Nuffield Trust think-tank, said: "All the stops are being pulled out to meet waiting times targets at A&E departments, a focus that is quite explicitly being driven by the election. But the cracks are showing.Nigel Edwards, chief executive of the Nuffield Trust think-tank, said: "All the stops are being pulled out to meet waiting times targets at A&E departments, a focus that is quite explicitly being driven by the election. But the cracks are showing.
"There have been big spikes in the numbers of people needing to be admitted to hospital in an emergency for reasons that are not very clear."There have been big spikes in the numbers of people needing to be admitted to hospital in an emergency for reasons that are not very clear.
"We may be reaching the point at which general practice, community services and social care can no longer contain the growing demand for their services.""We may be reaching the point at which general practice, community services and social care can no longer contain the growing demand for their services."
How the UK has prepared for winterHow the UK has prepared for winter
What has been your experience of A&E waiting times recently? You can get in touch via our Facebook page, Whatsapp on 07593 142 641 or by emailing haveyoursay@bbc.co.uk.What has been your experience of A&E waiting times recently? You can get in touch via our Facebook page, Whatsapp on 07593 142 641 or by emailing haveyoursay@bbc.co.uk.
Please include a telephone number if you are willing to be contacted by a BBC journalist.Please include a telephone number if you are willing to be contacted by a BBC journalist.
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