NHS: Waiting Times to Get Worse in A&E

The number of patients left on trolleys waiting for hospital beds is on track to triple in just three years, the British Medical Association has warned.

The dramatic rise in what is known as “trolley waits”, where patients are left waiting more than four hours for a hospital bed after a decision has been made to admit them, is attributed to three factors: falling staff numbers in accident and emergency departments, a lack of capital investment and the knock-on effect of bed-blocking.

The doctors’ union said the number waiting more than four hours for a bed would rise from 566,000 last year to 1.78 million by 2019-20. The BMA painted the grim picture of A&E health care after analysing what could be expected over the next three years. It concluded that there could also be a million more patients missing a separate target of bring treated in an A&E within four hours unless there was “urgent action to address rising demand”.

The detailed analysis by the BMA projects that the number of people attending emergency wards and waiting more than four hours for treatment could reach 3.7m in three years’ time, up from 2.6m in the year ending September 2017.

The forecast assumed that numbers would keep rising at the same rate as over the past five years and there would be a “do-nothing scenario” in which funding remained at its current level and the proposed measures to address pressures had little or no effect.

“UK spends less”

Dr Chaand Nagpaul (left), the chair of the BMA council, said the analysis revealed the scale of the challenge facing the NHS. “As demand increases and waiting times rise, many more patients are left waiting longer for care”, Nagpaul said. “It is clear from this analysis that we need urgent action to close the gap between investment and rising demand on the NHS.”

Leading doctors have said that already overstretched emergency departments in England could struggle to cope this winter if there is a major flu outbreak, such as that seen recently in Australia and New Zealand. They have cited staff shortages and high bed occupancy rates caused by a broader lack of funding, especially in social care, as contributing pressures.

There could be as many as 300,000 people a month waiting more than four hours at A&Es by December, according to the BMA analysis. That number could exceed 400,000 by 2020, meaning more than a fifth of patients attending emergency wards would have to wait more than four hours. The highest monthly figure in 2016-17 was 281,612, in January.

Rising Demand

The problems are being partly driven by an expected surge in attendances, which are predicted to hit 23.8m over the next 12 months – up 345,000 on 2016-17 – and 24.5 million in 2019-20.

Nagpaul added: “With the budget less than a month away, the Government needs to address the fact we spend about £10bn less per year on health that other leading European economies. Plugging this gap could fund, for example, another 35,000 hospital beds or 10,000 doctors, which could transform patient care.”

A Department of Health spokeswoman described the research and analysis as “rudimentary” and said that it oversimplified the trajectory of waiting lists. “Doing nothing was never an option for the NHS – we have given an extra £8bn investment by 2022 including £2bn for social care and £100m for A&E and last year, the NHS treated 2.2m more people in A&E within four hours than it did a decade ago,” she told The Guardian.

“The BMA is wrong to say we spend less per year on health than other leading countries; in fact spending on the NHS is in line with other European countries and our health service has, once again, been independently judged to be the best and most efficient health care system in the world.”

 

by Bob Graham

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