“Tens of thousands more patients spent more than 12 hours in A&E waiting for a bed last year than official figures suggest. Doctors and MPs called for a change to how “trolley waits” were reported in England after an investigation by The Times.
Official numbers show that 2,770 A&E patients had to wait more than 12 hours for a bed last year. These NHS statistics only capture the time between a doctor deciding a patient needs to be admitted and then being found a place on a ward. If the time is recorded between arriving at A&E and being found a bed, the number of patients who had to wait in emergency departments for more than 12 hours leaps to at least 67,406 patients, 24 times higher, according to data obtained under freedom of information laws.
The true figure is likely to be even higher, as only 73 hospitals out of 137 replied to the requests. The Times also asked hospitals for details of the longest wait they had recorded each week. Those revealed about 200 patients waiting more than a day for a bed last year. In December a 103-year-old woman spent 29 hours in A&E before she was admitted to the Great Western Hospital in Swindon, Wiltshire. The trust said that it had been one of the busiest months on record. The longest wait reported to The Times, of almost four days, was a 16-year-old boy at Barking Havering and Redbridge NHS Trust.
Sarah Wollaston, Conservative chairwoman of the health select committee, said that long waits in A&E raised patient safety concerns. “When departments are already at full stretch, having to care for individuals who may be very unwell and waiting for transfer to a more appropriate clinical setting reduces the time clinicians are free to assess and care for new arrivals and this can rapidly lead to spiralling delays,” Dr Wollaston said. “The total length of time that people are spending in emergency departments should be recorded alongside the current figures.”
Paul Williams, a Labour member of the committee, said: “If the clock doesn’t start ticking on ‘trolley waits’ until this decision has been made, then hospitals can legitimately have someone waiting for more than three hours to be seen and assessed, and then another 11 hours on a trolley without this leading to a breach of targets.” In Wales, Scotland and Northern Ireland, 12-hour waits are recorded from when a patient arrives in the department.
Rachel Power, chief executive of the Patients Association, said: “It’s clear from this data that many patients are enduring even longer waits with their safety, privacy and dignity compromised than the official statistics show.”
Taj Hassan, president of the Royal College of Emergency Medicine, said: “I think all independent observers would agree that, at the moment, the way we are describing our 12-hour trolley waits is not accurately describing the numbers.”
An NHS England spokesman said: “In the last 12 months to February 2018 the number of 12-hour trolley waits has dropped by more than 20 per cent on the previous year, and this has been achieved while hospitals also successfully looked after 160,000 more A&E patients within the four-hour target this winter compared to last winter.” NHS Digital is set to publish separate monthly statistics on the total number of patients spending more than 12 hours in A&E, whether or not they eventually needed admission. They said there were more than 260,000 during the financial year 2016-17.
Behind the story
Hospitals are expected to treat, admit or discharge 95 per cent of patients within four hours of their arrival at A&E (Kat Lay writes).
However, they have not met that target since July 2015. In January, only 77.1 per cent of people going to larger A&Es were dealt with within four hours.
For patients who require admission — “the sickest group” attending A&E, says the Royal College of Emergency Medicine — it appears to be worse.
At hospitals that provided figures to The Times, on average only 53 per cent of patients requiring admission were found a bed within four hours in January this year.
A lack of social care means that many of the beds that such patients need to be moved on to are taken up by people who do not need to be in hospital any longer, doctors complain.
Source: The Times (pay wall)