This site is intended for health professionals only

Half of London’s A&Es fail to hit waiting targets half the time

Over half the capital’s major A&E departments failed to meet the four-hour wait target at least half the time over the past year, a report has revealed.

The London Assembly report showed 12 out of 22 hospital trusts missed the Government target of 95% of patients being seen within four hours for at least half the year.

Dr Onkar Sahota, chair of the London Assembly Health Committee, said the findings were ‘extremely worrying’ and called for NHS England to publish – immediately – plans to deal with winter pressures in London to ensure they are adequate to deal with anticipated demand.

The report revealed six trusts missed the target at least 80% of the time and one – Barking, Havering and Redbridge University Hospitals Trust – missed it every week.

Only one trust – Chelsea and Westminster – consistently met the target.

Dr Sahota said: ‘Across the capital, A&E departments are struggling to cope with demand and more than half of trusts have failed to hit the Goverment’s target of dealing with people within four hours at least half the time.’

‘This is extremely worrying and as the winter sets in, with increased costs of heating, we believe emergency health services will struggle even more and patients in need of urgent care of emergency care will not be seen quickly enough.’

‘We immediately need to be given much more information on how hospitals and primary care are planning for the coming months so we can judge if they are adequately prepared.’

According to the report, only 10 trusts in London have been earmarked to receive funding as part of the Government’s £500m cash injection for A&E services nationally.

These 10 trusts –  eight of which missed the four-hour target at least half the year – are set to receive £55.4m between them, while the other four trusts that missed the target at least 50% of the time will not be getting any additional money.

However, the report stated: ‘Despite assurances to us from NHS England that the plans are now in place and would be published, they are largely not easily accessible or published at all, so it is not possible to judge whether they are likely to be adequate to enable A&Es to cope this winter.’

The report also calls for a longer term plan for ‘radical change’, including reform of primary care – which may involve ‘improving the service GPs can provide’.

The health committee said ‘there is broad agreement that more needs to be done through primary care service – i.e., GPs – and that reform to primary care in London is crucial for the future of A&E’.

However, RCGP chair Dr Clare Gerada – who is about to take over as NHS England’s lead on primary care reform in the capital – warned over further extra funds being given to A&E at the expense of primary care.

Dr Gerada said: ‘If we pour money to deal with this winter’s crisis into propping up urgent care or the emergency departments, even if we get some more investment in general practice, we are going to see a catastrophe in general practice.’

She said GPs ‘should be the front door of the NHS’ and it would be better to invest in increasing the capacity of GPs, district nurses and ‘wraparound services’ for elderly and young people instead of A&E.

The committee said it will be addressing changes to primary care – including steps to reduce pressure on A&E – ‘as a priority’, beginning at its next meeting in January.