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| Cameron defends NHS as A&E units record worst-ever performance | Cameron defends NHS as A&E units record worst-ever performance |
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| David Cameron has been forced to defend the performance of the embattled health service as official figures showed accident and emergency units in England recording their worst-ever performance. | David Cameron has been forced to defend the performance of the embattled health service as official figures showed accident and emergency units in England recording their worst-ever performance. |
| The prime minister’s intervention coincided with eight more hospitals declaring they had undergone a major or significant incident, taking the total reported so far this winter to 15, as the early stages of the election campaign headed into territory traditionally favourable to Labour. | The prime minister’s intervention coincided with eight more hospitals declaring they had undergone a major or significant incident, taking the total reported so far this winter to 15, as the early stages of the election campaign headed into territory traditionally favourable to Labour. |
| The prime minister insisted that the dramatic spike in A&E arrivals over the festive period represented “a short-term pressure issue” and criticised warnings of imminent meltdown in the NHS as scaremongering and irresponsible. | The prime minister insisted that the dramatic spike in A&E arrivals over the festive period represented “a short-term pressure issue” and criticised warnings of imminent meltdown in the NHS as scaremongering and irresponsible. |
| Health experts said the problems were caused by intense demand, a loss in confidence in GP availability – particularly by the young – and increasing hospital referrals by telephone-based 111 services, as well as patients’ failure to tolerate minor ailments. | Health experts said the problems were caused by intense demand, a loss in confidence in GP availability – particularly by the young – and increasing hospital referrals by telephone-based 111 services, as well as patients’ failure to tolerate minor ailments. |
| Between 15 and 21 December the NHS treated and either admitted or discharged 88.8% of patients seeking care at all types of urgent and emergency care units within four hours. This was below the 95% target, and the lowest proportion ever under the government’s preferred measure of A&E performance. | Between 15 and 21 December the NHS treated and either admitted or discharged 88.8% of patients seeking care at all types of urgent and emergency care units within four hours. This was below the 95% target, and the lowest proportion ever under the government’s preferred measure of A&E performance. |
| Emergency departments treated just 83.1% of those arriving that week at so called type 1 A&E units – those based at hospitals – which was also the worst figure since records began 10 years ago. | |
| Some experts see that measure as a more accurate reflection of how patients needing emergency care are looked after as it does not include walk-in centres and urgent care centres. | Some experts see that measure as a more accurate reflection of how patients needing emergency care are looked after as it does not include walk-in centres and urgent care centres. |
| A slightly better performance between 22 and 28 December – which saw performance reach 90.5% and 85.7%, depending on which measurement is used – did nothing to relieve a growing sense in the NHS that it is facing some of the greatest pressures in memory. | A slightly better performance between 22 and 28 December – which saw performance reach 90.5% and 85.7%, depending on which measurement is used – did nothing to relieve a growing sense in the NHS that it is facing some of the greatest pressures in memory. |
| Andy Burnham, the shadow health secretary, said that the Christmas figures “confirm the serious deterioration in the NHS under this government but reveal, more worryingly, a dangerous slump in A&E performance in recent weeks”. He blamed deep cuts to local councils’ social care budgets and the coalition’s reorganisation of the NHS. | |
| The leaders of Britain’s doctors and nurses said A&E units’ increasing struggle to cope with ever-rising numbers of patients were the result of problems elsewhere, such as failings with the NHS 111 telephone advice service, staff recruitment problems and the lack of social care services to help older people stay as well as possible in their own homes. | The leaders of Britain’s doctors and nurses said A&E units’ increasing struggle to cope with ever-rising numbers of patients were the result of problems elsewhere, such as failings with the NHS 111 telephone advice service, staff recruitment problems and the lack of social care services to help older people stay as well as possible in their own homes. |
| “Patients should be treated on the basis of need, rather than arbitrary targets, but these figures show the NHS is under unprecedented levels of pressure. Staff are working flat out but the system is struggling to cope with the sheer number of patients coming through the door. “ | “Patients should be treated on the basis of need, rather than arbitrary targets, but these figures show the NHS is under unprecedented levels of pressure. Staff are working flat out but the system is struggling to cope with the sheer number of patients coming through the door. “ |
| Growing pressure on services throughout the year means hospitals have no spare capacity to deal with the winter spike in demand. So patients are enduring delays in their treatment, and the NHS finds itself running just to stand still,” said Dr Mark Porter, the leader of the British Medical Association, which represents doctors. | Growing pressure on services throughout the year means hospitals have no spare capacity to deal with the winter spike in demand. So patients are enduring delays in their treatment, and the NHS finds itself running just to stand still,” said Dr Mark Porter, the leader of the British Medical Association, which represents doctors. |
| Dr Peter Carter, chief executive of the Royal College of Nursing, said the loss of 6,500 district nurses in the last decade had also increased the pressure on hospitals because frail, elderly people and those with long-term conditions are not as well-supported as before, he added. | |
| Professor Keith Willett, NHS England’s director of acute care, admitted that the A&E system was “running absolutely hot” at the moment. A&E attendances were up 9% over Christmas compared with the same time the year before, and admissions were 6% higher then than in 2013. In addition, ambulance services experienced a 9% year-on-year increase in 999 calls and NHS 111 handled its highest-ever number of calls in one week – 440,000, compared with a weekly average of 230,000. | |
| One hospital, the Great Western in Swindon, had to erected a large tent on Monday to deal with an influx of patients and cancelled all non-essential operations at the hospital for a second day. The hospital trust said that it was dealing with an increased demand on its services but said it did not declare a major incident. It also said the tent was removed on Tuesday. | |
| Claire Murdoch, the chief executive of the Central and North West London NHS Foundation Trust, said too many patients are clogging up the system because they are too quick to seek help at an A&E or GP’s surgery for minor illnesses such as a sore throat, cold, flu or virus. More people should be prepared to treat their symptoms with rest, painkillers and fluids instead of immediately seeking the opinion of an overworked doctor, she said. | |
| Inquiries by the Guardian show that eight more hospitals have been forced to declare some sort of serious incident in recent weeks because of their inability to deal with the demand for care. Peterborough city hospital cancelled eight operations on Tuesday , after cancelling nine on Monday, to prioritise emergency care. | Inquiries by the Guardian show that eight more hospitals have been forced to declare some sort of serious incident in recent weeks because of their inability to deal with the demand for care. Peterborough city hospital cancelled eight operations on Tuesday , after cancelling nine on Monday, to prioritise emergency care. |
| Walsall Manor hospital is trying to open a new 30-bed ward early next week to help take the strain. It said it has cancelled some planned surgery, scaled back staff training and was ensuring outpatient clinics were not taking staff away from the emergency frontline. | Walsall Manor hospital is trying to open a new 30-bed ward early next week to help take the strain. It said it has cancelled some planned surgery, scaled back staff training and was ensuring outpatient clinics were not taking staff away from the emergency frontline. |
| The trust chief executive, Richard Kirkby, said: “We have put arrangements in place so that we are able to focus on the priority of ensuring we can care safely for the patients already in the hospital.” | The trust chief executive, Richard Kirkby, said: “We have put arrangements in place so that we are able to focus on the priority of ensuring we can care safely for the patients already in the hospital.” |
| GPs in Bedford received a message through an online system for doctors on Tuesday afternoon saying Bedford hospital had declared a significant incident. The message title was: “A significant deterioration in the resilience of the Bradford Hospital emergency care system.” | GPs in Bedford received a message through an online system for doctors on Tuesday afternoon saying Bedford hospital had declared a significant incident. The message title was: “A significant deterioration in the resilience of the Bradford Hospital emergency care system.” |
| And Brighton and Sussex University hospitals trust, which termed its incident “significant”, said the Princess Royal Brighton and the Royal Sussex had cancelled some appointments, clinics and operations but did not provide further details. | And Brighton and Sussex University hospitals trust, which termed its incident “significant”, said the Princess Royal Brighton and the Royal Sussex had cancelled some appointments, clinics and operations but did not provide further details. |
| The NHS defines a major incident as “any occurrence that presents serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance trusts or other acute or community provider organisations.” | The NHS defines a major incident as “any occurrence that presents serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance trusts or other acute or community provider organisations.” |
| Additional reporting by Jonathan Bucks and Ashley Kirk | Additional reporting by Jonathan Bucks and Ashley Kirk |