Emergency Services Faces ‘Significant Pressures’ as Waiting Times Hit Record Highs

The latest (June 2022) data on NHS Emergency Services reveal worsening pressure on the healthcare system, with patients in England waiting substantially longer for ambulances, Emergency Departments, and other hospital treatments.

The waiting time figures surpass any ‘winter crisis’ on record, a time when Emergency Departments demand typically peaks. The NHS fared worse than ever in a month when it is usually less busy.

Commenting on the figures, the director of communications at NHS Providers, Adam Brimelow, said: “The summer months traditionally would have been a point where you would expect real inroads to be made on waiting lists.”

NHS Wait Times Getting Worse

Waiting times are a key measure that helps highlight the performance of the NHS. The speed at which someone is brought to the hospital, assessed by a doctor in the Emergency Department and admitted for further treatment is essential for the patient experience and the clinical outcomes.

Emergency Department Waiting Times

Emergency Department waiting times typically refer to the time between the decision to admit for further treatment and when a patient is actually admitted. NHS England is held to a four-hour standard, which recommends that at least 95% of Emergency Department visits should be admitted, discharged, or transferred within four hours.

Emergency Department waiting times have been worsening in recent years, with the NHS unable to meet the four-hour standard since 2013/2014. Figures show that June 2022 was the busiest June on record, with 2.8 million Emergency Department visits. This coincided with worrying waiting times as shown:

  • Emergency Department waiting times of over 12 hours soared to 22,034 in June 2022. This is 47 times more than the last equivalent month pre-pandemic—where June 2019 recorded 462 cases.
  • 130,109 patients waited at least 4 hours for admission, up from 122,768 in May 2022.
  • Both the 12 hours+ and 4 hours+ A&E waiting times for June 2022 were worse than winter figures for the first time ever—which includes 130,109 vs. 119,285 (winter) for four-hour waits and 22,034 vs. 15,349 (winter) for 12-hour waits.

Ambulance Services

June 2022 saw a record high of 900,000 calls to 999 and worsening ambulance response times in the following emergency categories.

  • Most Urgent Incidents (Life-threatening injuries or illnesses): Average ambulance response time for June 2022 was 9 minutes and 6 seconds, against the 7-minute standard or the 8 minutes and 36 seconds recorded in the previous month.
  • Emergency Calls (Strokes, burns, epilepsy, etc.): Response time increased sharply from 39 minutes and 58 seconds in May to 51 minutes and 38 seconds in June 2022. The standard target is set at 18 minutes.
  • Urgent Incidents (Non-severe burns, late-stage labour, etc.): Ambulances took 2 hours, 53 minutes and 54 seconds on average to respond to urgent incidents, compared to 2 hours, 9 minutes and 32 seconds in the preceding month.

The president of the Society for Acute Medicine, Dr Tim Cooksley, expressed his concern about ambulance response time saying:

Patients are being stuck for extortionately long periods in emergency departments. ….Due to this, paramedics are then stuck, unable to transfer their patients into hospitals and get back on the road, resulting in 999 patients being left at home for longer periods without clinical assessment and treatment, driving public concern that they may not get an ambulance at their time of most need.”

Waiting List

The summer months are typically when hospitals work on reducing their waiting lists. However according to the latest figure, the list has been growing for the last 2 years.

NHS England is currently working through its biggest backlog of elective care on record. Some 6.6 million (or 1 in 9) people in England were on a hospital waiting list at the end of May 2022. This represents an additional of 2.75 million people since the pandemic.

Mounting Pressure on NHS Emergency Services

Where does the problem lie? A wide range of factors could be worsening waiting times including; reduced capacity (staff and infrastructure), changes in clinical practice and demand for healthcare services.

As Mr Brimelow puts it:

It’s not an A&E problem, it’s the whole system. There are people in hospitals who are fit enough to be released but still need some sort of care, but there is no space in social care settings for them to go to….That means you can’t admit people from A&E that need to be admitted. That means A&E is busy, and when ambulances come along, they have to wait outside because A&E is full. There is a lack of capacity throughout the system.”

The June figures show that around 11,590 patients who were fit for discharge remained in the hospital each day due to challenges with social care placement. Additionally, Covid-positive patients occupied over 13,000 beds, with the virus also causing 26,874 NHS staff absences.

The national medical director for NHS England, Professor Sir Stephen Powis, acknowledged the challenges facing the NHS, saying:

There is no doubt the NHS still faces significant pressures, from rising Covid admissions, thousands of staff absences due to the virus, the heatwave, and record demand for ambulances and emergency care…While the current heatwave is not shown in today’s figures, it also affects NHS capacity.”

Whilst also calling for continued community and social care and urging anyone needing emergency care to dial 999 or 111 if non urgent and using local pharmacies for other health issues and advice.

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