Missing targets is now standard in the NHS

The Times reports 14th Jan 2015: Missing targets is now standard in the NHSWhilst the Mark Tran in the Guardian reports: NHS misses key targets in run-up to busy winter period – Number of patients seen within four hours at lowest since targets were introduced as hospitals face surge of cases over winter – And its got to get worse

The NHS in England missed several key targets for A&E admissions, cancer referrals, ambulance response times and NHS 111 calls in September as it braces itself for a busy winter period.

Against a target of 95%, 93.4% of patients attending emergency departments were seen within four hours in September. The figure was 94.3% the previous month. The A&E data for September is often cited as an indicator of pressure on the NHS as it prepares for winter.

Dr Mark Holland, president of the Society for Acute Medicine, has warned that A&E units are facing a a nightmarish scenario that will heap on the pressure in the buildup to winter. He told Sky News that a lack of staff and possible industrial action by junior doctors were very worrying at this time of year, adding there had been a rise in the number of patients needing emergency care.

Last winter, from the beginning of October to the end of December, 92.6% of patients were seen within four hours, the worst quarterly performance since the target was introduced at the end of 2004. The data, published by NHS England, is for all A&E types, including minor injury units and walk-in centres. It refers to the number discharged, admitted or transferred within four hours of arrival.

NHS England also missed other targets. The 62-day wait for cancer treatment from GP referrals was 81.5% against a target of 85%, the 17th month in a row it has been missed. The 14-day wait for patients with breast cancer symptoms was 92.7% versus 93%, the third month in a row the target has been missed.

Annual numbers for cancer referrals show the NHS continues to miss its targets. The proportion of people waiting no longer than 62 days for a referral has fallen each year since a peak of 87.2% in 2012/13. The figure for 2015/16 to date is 81.9% – 3.1 points below the target.

Ambulance “red 1” critical calls responded to within eight minutes was 72.9%. The target is 75%. It is the fourth month in a row it has been missed. “Red 2” immediately life-threatening calls responded to within eight minutes was 68.9%. The target is 75% and it has not been met since January 2014.

NHS 111 calls answered within 60 seconds was 91.4%. The target is 95%. This was the lowest figure for any month of the year so far.

Responding to the September data, Heidi Alexander, the shadow health secretary, said: “These figures show that the NHS is facing breaking point before winter has even started. It is a stark illustration of just how far the NHS has declined under the Tories. Unless there is an urgent and significant injection of money into the NHS, then standards of care will be compromised this winter.”

Earlier this week, Christopher Smallwood, chairman of St George’s University Hospitals NHS foundation trust, which serves 1.3 million people in south-west London, warned that years of underfunding have left hospitals short of staff and unable to meet waiting time targets for cancer and A&E care.

In an article for the Guardian, Smallwood accused ministers of being in denial about the seriousness of the situation facing the health service, and its root causes. He said the health secretary Jeremy Hunt’s insistence that the NHS deliver £22bn of efficiency savings by 2020 as “for the birds”.

Prof Chris Ham, chief executive of the King’s Fund health thinktank, said everyone involved in the NHS would recognise Smallwood’s warnings as an accurate portrayal of a service struggling to cope with five years of the smallest budget increases in its history.

“Patient care is starting to suffer” and NHS leaders face an impossible task of either trying to balance their books or ensuring they have enough nurses and doctors to care properly for patients, Ham said.

He said there was “a real risk of a return to the 1990s, when patients had to wait 18 months or longer for planned operations”, adding that there was no prospect of introducing the seven-day NHS without more money.

John Appleby, chief economist at The King’s Fund, said: “Today’s figures show the NHS struggling to maintain performance in the face of rising demand for services.

“With winter approaching the NHS faces a toxic mix of financial deficits, rising waiting times and low morale. This is a reminder for the chancellor that the additional funding for the NHS promised for the spending review is needed sooner rather than later.’

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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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