Huge pressures at hospitals across the NHS over the last month have led to long delays for patients seeking emergency care, figures suggest.
The NHS England December data showed record delays in A&E with one in five patients waiting more than four hours.
A key problem seems to have been a shortage of beds on wards.
The figures show nearly 100,000 of the sickest patients faced hours stuck on trolleys and waiting in corridors while beds were found for them.
Some hospitals were even forced to introduce emergency protocols and turn away walk-in patients deemed not to need immediate help, while many have postponed routine operations to fee up space.
‘My father-in-law spent 25 hours waiting for a bed’
Mark Newton’s 83-year-old father-in-law, George Bufton, was taken to a hospital in the Midlands in the first week of January.
He had a chest infection and a suspected gall bladder problem – and this came just over a month after he’d had a major bowel cancer operation.
He spent 25 hours waiting for a bed to be found.
Mr Newton said he was “gobsmacked” by what he saw.
At one point around 20 trolleys were stuck waiting in the corridor, with queues of ambulances outside A&E.
He said staff were doing an “admirable” job in the circumstances, but there was just not enough money or staff to cope.
“It was utter mayhem. This can’t continue. Something must be done about it,” Mr Newton said.
How bad has it been?
December was certainly the worst month since the four-hour target was introduced in 2004.
Just 79.8% of patients spent less than four hours in A&E – well below the 95% target.
Three trusts – Norfolk and Norwich, Stockport and Hull – all saw performance drop below 60%, while a group of Midlands trusts – Shrewsbury and Telford, Leicester, Birmingham and United Lincolnshire – were all in the 10 worst performers.
Waiting times have been getting gradually worse over the autumn – October and November saw record worst levels set as well.
But the problems in emergency care has not just been confined to A&E waits.
The number of patients who then needed to be admitted on to the ward and faced long delays also hit a new worst level.
There were 98,500 patients who faced a so-called “trolley wait” of a further four hours.
That is nearly one in four of the patients who needed to be admitted.
These “trolley waits” can be in corridors or temporary waiting areas, either in A&E or just outside.
Patients who are admitted are often the sickest of those who attend A&E.
But it is not just A&E units that are struggling. The waiting time targets for cancer treatment and routine operations, such as knee and hip replacements have also been missed.
What is the cause of the pressures?
Hospital bosses acknowledged it had been one of the most difficult months they had seen – and this comes despite the extra money the government has put in this year, which saw the NHS budget grow by 3.5%.
There are a variety of reasons behind the problems.
Prof Joe Harrison, chief executive of Milton Keynes Hospital, said his staff had been seeing some very sick patients.
He said it had mainly been a combination of older patients and children, who seemed to have been particularly hard hit by flu and respiratory problems.
Although the figures also show that the number of beds that have had to be closed to contain vomiting and diarrhoea outbreaks has risen by more than 60% compared to last year with 760 beds closed on average each day last month – that is closed to 1% of the bed supply lost.
Prof Harrison also said the social care system in the community, which hospitals rely on to discharge patients into, seemed to have been struggling more than it was last year.
“Keeping people safe has been our main priority. There is significant pressure, not just in this hospital, but across the NHS system as a whole,” he said.
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