A&Es report busiest months as hospitals face ‘most challenging winter yet’

Hospitals are heading into winter already under huge pressure - with packed A&Es and rising waiting lists.

A&Es across the country saw their busiest September ever, and waits to be admitted to wards were worse than any winter, while the number waiting to see a consultant hit 5.7 million, with nearly 10,000 people having already waited more than two years.

There were 23,487 attendances at A&Es run by University Hospitals of Leicester NHS Trust in September, the highest number since monthly records began in June 2015.

Just 56.8% of those attending last month were admitted, discharged or transferred within the target of four hours.

For those admitted, waits for a ward bed were also rising - 2,278 waited more than four hours, up from 2,095 in August, with 148 waiting more than 12 hours, both record highs.

Numbers waiting for elective treatment at Leicester’s hospitals are also high - 103,011 in August. That was the highest number on the waiting list since records began in August 2007.

Of those waiting, 51.7% had been waiting less than 18 weeks, compared to 53.1% in July.

The number waiting over a year for treatment rose to 11,696 from 11,167 in July, and 3,137 in August last year.

There were also 768 people who had been waiting more than two years for treatment.

Responding to the latest performance figures for the NHS in England, Matthew Taylor, chief executive of the NHS Confederation, said: “These figures once again demonstrate just how extremely hot the health service is running, and the intense pressure it continues to face as it heads into a very challenging winter. Rather than stumbling into crisis the government needs to recognise the inevitability of severe winter pressures and to explore how we can mobilise a national effort to support the health and care system through the coming months.

“The NHS will continue to do everything it can for its patients, but stretching the service so thinly is a dangerous game.”

The new figures show 2.1 million visits to A&E last month - the busiest September on record.

A quarter of those (24.8%) waited more than four hours to be admitted, discharged or transferred, which was the worst performance in more than decade. Once admitted, 104,875 waited more than four hours for a ward bed, with 5,025 waiting more than 12 hours - the highest numbers since records began in November 2010.

For those needing non- emergency treatment, the waiting list hit a record 5.7 million, with one in 20 waiting over a year for treatment. The number waiting more than two years has also grown to 9,754.

While the number waiting more than a year dropped in August, the decline has slowed, and there was also a slow down in the number of procedures carried out - 1.1 million in August, down from 1.3 million in June and July.

A survey of trust leaders by NHS Providers has revealed widespread worries that rapidly growing waiting lists will worsen existing health inequalities - with all who responded concerned, and two in three very concerned.

The deputy chief executive of NHS Providers, Saffron Cordery, said: “Trust leaders are fighting fires on multiple fronts as they try to recover care backlogs, deal with increased demand for emergency care, treat patients with Covid-19 and prepare for what is likely to be the most challenging winter yet for the NHS.

“In a matter of weeks, we will face our first winter where both flu and Covid are in circulation. NHS staff are doing all they can to bear down on the care backlog, but the reality on the frontline is that even a small increase in flu, Covid-19 admissions or emergency care attendance will really increase the pressure on the service.

“The impact the care backlog could have on worsening health inequalities weighs heavy on the shoulders of trust leaders.”

She said it was reassuring that trusts were working with others in the health and care system to manage waiting lists to prioritise the sickest patients, and finding ways to use of virtual appointments where appropriate, and digital transformation of some manual processes to reduce the administrative burden on clinicians, freeing up more time to care for patients.

However, what trusts need most is new staff.