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Emergency admissions reach record high

Emergency admissions are at their highest since records began 10 years ago, according to new figures from NHS England.

Figures for the week ending 7 December show that there were 436,229 individual attendances at A&E departments – nearly 4,000 more than week before, and over 20,000 more than at this time last year.

Last week also saw nearly 5,000 more emergency admissions than were recorded for the same week in 2013, at 110,100.

NHSE’s latest ‘winter health check’ report also shows that record numbers of patients are waiting longer for treatment in A&E departments, despite the NHS’s claims that they are ‘pulling out all the stops’ to open extra beds and seven-day services using extra winter funding provided by the Government.

While the NHS’s own target is for 95% of patients to be admitted, transferred or discharged within four hours of presenting at A&E, the report also showed that only 91.8% of patients attending A&E last week met with this target – compared to 94.8% the year before.

BMA chair Dr Mark Porter said that the figures showed a system ‘cracking under extreme pressure’, and warned that GPs were struggling to cope.

He said: ‘While the NHS is used to seeing a spike in demand during winter months, this year it’s experienced a spring, summer and autumn crisis as well, leaving no spare capacity in hospitals as we hit winter.

‘This is not just a crisis in emergency care – bed shortages and high numbers of patients inappropriately in hospital beds are now major stress factors on the system, leading to unacceptable delays in treating and discharging patients. Outside of hospitals, GP surgeries are struggling to cope with unprecedented levels of demand.’

He added: ‘Patients should be treated on the basis of clinical need rather than an arbitrary target, but these figures point to a system cracking under extreme pressure, leading to unacceptable delays in care.’

Dr Barbara Hakin, national director of commissioning operations for NHS England, said: ‘Unsurprisingly, this level of demand continues to put extra pressure on our hospitals but the NHS remains resilient and is pulling out all the stops, with local hospitals, ambulances, GPs, home health services and local councils all working hard to open extra beds and seven-day services using the extra winter funding that has been made available.’

But Dr Porter said that while frontline staff were working ‘flat-out’ to meet the added demand, the system ‘can’t cope with the sheer number of patients coming through the door’.

He said: ‘So far there has been a total failure by Government to come up with a meaningful plan to deal with this – funding announced recently to tackle winter pressures is simply recycled money, taken from other overstretched services.

‘There is no getting away from the fact that the NHS needs more investment to ensure there are enough staff and resources to meet rising demand, and part of this means taking urgent action to address the high number of staff vacancies in emergency medicine as well as general practice.’

Readers' comments (18)

  • Can we now please stop the ridiculous Admission Avoidance DES, and all the time wasting in MDT meetings and writing up 'care plans?'

    Admissions up 7% cf last year across the country - it plainly DOES NOT WORK.

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  • That's top down planning for you. Simplistic ideas from DoH translating into bureaucratic waste at the coal-face. Money & time is now thrown at giving well people chronic disease labels that only increase our workload leaving us with little time & energy to deal with those who are really sick. Health promotion is everyone's business & shd not fall mostly on GPs to sort out.

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  • Because minor injury and urgent care centres are included in A+E performance statistics, this distorts the picture of what is happening in major A+Es. The 4 hour performance in those fell to 87.7% in the first week of December. Interestingly attendances at major A+Es were higher throughout June and July yet the 4 hour target was generally maintained above 92%. The reason for the current drop in performance then is not primarily due to high attendance rates but high admission rates into a system that does not have the capacity to deal with them - hence the dramatic rise in trolley waits (those waiting 4-12 hours between decision to admit and admission). This was 7760 in the first week of December, compared with around 4000 in the summer weeks. This is caused by a number of factors including insufficient A+E capacity (staff, space, diagnostics), insufficient beds to admit people to (due to absolute bed cuts and also relative reduction due to delayed discharge.) Delayed discharges are at their highest since current data set began in 2010. This in turn is related to the drastic cuts in social services budgets. Its convenient to say the problem is too many patients going to A+E which easily morphs into blaming patients (and GPs) and enables the Government to ignore the true cause of this crisis which is a combination of cuts to hospitals, GPs, community and social services, closures of A+Es, cuts to bed numbers and deficiencies in staff recruitment and retention - at the same time as entirely predictable rising demand due to population growth and demographic change. All this could have been predicted and planned for. Instead we have cuts. And then the Government pretends it doesn't know why it is happening and throws some money at it in the hope of averting a damaging political crisis. Patients are suffering now and will suffer more over what looks like being a horrible winter. It does not have to be this way. Proper planning and proper investment in NHS services is what is needed, not these ineffective panic measures.

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  • The people in government running the show (i.e Hunt, Lord Howe etc etc ) are incompetent ...of cause they are. If you weren't born with an hereditary title (Lord Howe) you get to win power in this country by making the right chums at Oxford or Cambridge, then go work as a researcher for some politician, gaining skills in PR media managment and hob nobbing with the right people in a suburb of London somewhere. Why that would qualify you to run a country I don't know, but suitably kitted out with an absolute certainty of their own amazing/superior intellect they micro manage everything and low and behold ...it turns out they are actually pretty crap at it...never mind, soon the new guy (who weirdly they went to school with) takes over and they can move on.

    That's why the NHS is in the mess it is...the country is run by prats...and has been for quite some time.

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  • Jeremy hunt - Magdalen College Oxford
    David Cameron - Brasenose College Oxford
    Lord Howe - Christ Church Oxford
    Edward Miliband - Corpus Christi College Oxford
    Nick Clegg - Cambridge University (odd one out)

    Maybe it's time we had some leaders with a bit more breadth ...inbred stale bunch of losers

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  • The problem is simply one of population increase. No new hospitals and yet a growth from 25 million 20 years ago to 70 million with no real investment in infrastructure manpower or education.Every newspaper tells the patient to seek medical help and the internet "terrifies the patient" into believing evey small problem might be the BIG problem. Received two calls this am ( of many) a) I have had a knee pain for 2 hours - advice please and appointment b) I have been sick since I awoke can you get me admitted for endoscopy ? No comment.

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  • If you cut budgets and staff and beds when the population ages and increases in number, then you have this chaos. Mid-Staffs was a clear example of a top star hospital falling prey to staff cuts.
    All this while they pay management Consultants £4000 a day AND blame GPs who already see 92% of consults on 8% of the budget.
    In other words, secondary care cannot manage 8% on 92% of the money.
    Nationwide. It cannot be that ALL doctors are lazy.
    There are not enough beds or staff to run the NHS, thats all.
    Sure, you can spend another £700 million on Management Consultants, mostly friends of above mentioned College folk, but it is not going to get any better

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  • The true crises is in the set up of emergency care. Having been an AE SHO, the department is mainly run on inexperienced junior doctors, with 1 registrar and a consultant who is often not on the shop floor.

    As a junior doctor I would admit a lot of patients I would never do now. He registrars are too busy for any sensible teaching. Also once the Patietn got close to 4 hours they would be admitted.

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