Nearly a fifth of patients waited more than four hours in a Birmingham A&E in the last week of December as three-quarters of hospital trusts across the city missed the target for seeing patients.
The worst performer in the last week of December (to December 28) was Heart of England hospitals, where just 82.2% were seen in four hours. The trust has missed the target for 19 weeks.
A similar proportion are waiting too long at Walsall Healthcare NHS Trust, 83.3%, which has missed the target for 13 weeks running.
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More than one in 10 patients is waiting too long at Sandwell and West Birmingham NHS Trust, 87.5%, which has missed the target for 18 weeks running with the last time it hit the target in the week ending August 31, and Royal Wolverhampton NHS Trust, 89.8% were seen in four hours, missing the target for 11 weeks running.
Birmingham Children’s Hospital NHS Trust saw 94.7% of patients in four hours, almost hitting the target after falling to 78.2% in the week to November 30.
University Hospitals Birmingham and the Dudley Group hospitals were the only ones to meet the target.
Across England, the target to see patients in A&E in less than four hours has been missed for an entire quarter, as performance fell to its lowest level in a decade.
Between October and December, just 92.6% of patients arriving in English A&Es were seen in less than 4 hours. The target is 95%. The performance is the worst quarterly result since the target was introduced at the end of 2004.
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In the most recent week, ending December 28, nearly one in 10 patients (9.5%) waited more than four hours before being admitted, transferred or discharged. This is the first time the target has been missed for 13 weeks running since the week ending April 21, 2013, equalling that run of missed targets. Since the end of August the 95% target has only been hit in one week.
The weeks leading up to December 14 and December 21, were the first time the proportion of patient seen in four hours has dipped below 90%, with just 88.8% seen in time in the week to December 21.
Major A&Es are continuing to struggle, with one in seven, 14.3%, patients waiting more than four hours from arrival to admission, discharge or transfer in the week to December 28.
The worst performing trust in England was Cambridge University Hospitals NHS Foundation Trust, where a third, 34%, of patients waited more than four hours in the week to December 28. More than a quarter waited more than four hours at Colchester Hospital Trust, Hull and East Yorkshire Hospitals Trust, Stockport NHS Trust, University Hospitals of North Midlands Trust and Wye Valley NHS Trust.
Responding to the publication of figures which show pressures in England’s A&E departments has now reached record levels, Dr Mark Porter, BMA council chair, said: “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.
“Doctors must be able to treat the patient who’s in front of them based on their individual needs, which is why doctors don’t agree with targets for targets’ sake. Moving away from a system which prioritises targets above all else can help to improve the quality of care doctors are able to give patients by preventing rushed admissions or leaving those most in need waiting longer for treatment. But this will only work in the best interests of patients if the NHS has the staff and resources it needs to meet rising patient demand.
“In the longer term, for the NHS to meet rising demand we need to address the underlying problems in the system. Preventing unnecessary A&E admissions by having an effective, out-of-hours telephone service is an important part of this, so there needs to be a marked improvement in NHS 111 to ensure it is clinician-led. We also need a long-term solution to the crisis in social care, to reduce the number of patients being inappropriately held in hospitals. Outside of hospitals, we need to support general practice which is struggling to cope with unprecedented levels of demand and a shortage of GPs. There is no getting away from the fact the NHS needs more investment, so we must also ensure that plans to deal with rising demand on the NHS, as outlined in the Five Year Forward View, are backed with proper funding.”