“Compared to seven years ago, we are treating 3,000 more people within the four-hour standard”
That’s what Jeremy Hunt told Channel 4 News last night.
He was referring to the national standard that says 95 per cent of patients should be admitted to hospital, transferred or discharged within four hours of arriving in A&E.
It’s true that the number of people being treated within the four-hour target has gone up compared to seven years ago.
But the total number of patients attending A&E has gone up in that time too.
What Mr Hunt didn’t mention was that since his government has been in office, the proportion of patients being admitted, transferred or discharged within four hours has fallen – and the total number of people waiting more than four hours has risen six-fold.
The proportion of patients treated within four hours has fallen below the 95 per cent target
We’re going to compare figures by quarter (e.g. January to March 2010 versus January to March 2017). That’s because there are more hospital and casualty admissions in winter than at other times of the year – so the summer months will perform better.
So what does the data show?
In the first three months of 2010 – just before the Tories took office – 96.9 per cent of patients in A&E were seen within four hours. By the first quarter of 2017, that had dropped to 87.6 per cent.
Even when we compare summer periods – when hospitals tend to be less busy – there’s also a drop.
In July to September 2010, 97 per cent of patients were seen within four hours. By July to September 2017, that figure had fallen to 85.2 per cent.
The number of patients waiting more than four hours has risen six-fold since 2010
And the picture’s worse when we look at the actual number of patients who have to wait more than four hours in casualty departments.
In the three months up to March 2010, just over 100,000 patients waited over four hours for treatment. In the first quarter of 2017, that figure stood at just under 700,000.
The most recent quarter-by-quarter figures we have cover the three months between July and September 2017. In that period, there were 586,000 patients waiting more than four hours in A&E. The same period in 2010 saw 106,000 patients waiting four hours or more.
That’s a summer-to-summer increase of nearly 600 per cent.
The latest month-by-month data is for November 2017, when 222,000 people waited over four hours. In November 2010, that figure was 46,000. That’s a rise of nearly 500 per cent.
What about the emergency funding boost?
You might remember that in November, Philip Hammond announced an extra boost to the NHS budget to help relieve pressure on services.
He pledged £337 million for this winter, and £1.6 billion for 2018-19.
But that was after the Kings Fund, the Nuffield Trust and the Health Foundation told the government that the NHS needs at least an extra £4 billion this year alone.
It’s no surprise then, that the Chancellor’s announcement was met with lukewarm support: the boss of NHS England, Sir Malcolm Grant, said that while they welcomed the extra money, it would only go “some way to filling the widely accepted funding gap”.
“We can no longer avoid the difficult debate about what is possible to deliver for patients with the money available” he added.
Is this about staffing numbers?
“In the period I’ve been Health Secretary, we actually have 40,000 more doctors, nurses and clinicians”
Mr Hunt is correct: there are 40,000 more doctors, nurses and other clinical staff working in the NHS than there were when he became Secretary of State in 2012.
But, as the draft workforce strategy from Health Education England points out, in that time, “England’s population has grown by 2.1 million, and has continued to age. The number of people with long-term conditions has grown sharply.”
While the government has announced a 25 per cent increase in medical school places from 2018-19, those doctors will only become consultants or GPs by 2030 at the earliest.
Mr Hunt acknowledged this, and told the programme last night that he’s asking staff to “bear with us.”
But it’s not just a problem of creating roles and training places – it’s also about vacancies and staff retention. The Health Education England report points out that there are currently 42,000 vacancies across the NHS for nurses and midwives.
And “the vast majority of vacant posts do not translate into vacant shifts as most are covered by bank or agency staff, but using agency staff is expensive and continuity of care can be compromised.”
According to the report, about 8 per cent of vacant shifts remain uncovered – and in some regions, like London, that figure is as high as 15 per cent.
The report also highlights that the percentage of nurses leaving the NHS for reasons other than retirement increased from 7.1 per cent in 2011-12 to 8.7 in 2016-17.
By their calculations, “had the rate [of nurses leaving the NHS for reasons other than retirement] remained at 2012 levels through to 2017, we would have 16,000 more nurses working in the NHS today – that’s almost half of our currently vacant nurse posts filled.”