Spiral of decline in urgent and emergency care evident every month – SAM president

The latest NHS performance data released today shows, among other things:

*73.3% of patients were seen within four hours in all A&E departments this month compared to 74.0% in May 2023 and 72.1% in June 2022. The 95% standard was last met in July 2015.

* There were 114,000 four-hour delays from decision to admit to admission this month, which compares to 130,000 in June 2022. Of these, 26,500 were delayed over twelve hours (from decision to admit to admission), which compares to 22,000 in June 2022.

*The number of referral to treat (RTT) pathways where a patient was waiting to start treatment at the end of May 2023 was 7.5 million.

*The total number of patients waiting six weeks or more from referral for one of the 15 key diagnostic tests at the end of May 2023 was 409,700. This was 25.9% of the total number of patients waiting at the end of the month against a national operational standard of less than 1% of patients waiting six weeks or more.

Dr Tim Cooksley, president of the Society for Acute Medicine, said: “NHS urgent and emergency care is under intolerable strain and this strain is increasingly causing harm, with older patients often bearing the brunt of the problem.

“Timely and high-quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints.

“This is evident with every monthly data release, with performance against the four-hour for June at 73.3%, 12-hour waits at 26,500 and the added challenges of a treatment waiting list of 7.5 million and the risks to health that brings with it.

“There has been a spiral of decline in urgent and emergency care lasting a decade now and, unless urgent action is taken, we may not yet have seen the worst of it.

“Current trajectory suggests winter 2023 will be worse than the  dire experience of 2022 and that is deeply concerning.

“While it is true that more people are accessing emergency care, this increase alone does not explain the disproportionate drop in performance. This situation must not become an unacceptable new normal or indeed continue the current decline.

“Despite the recent publication of the NHS Long Term Workforce Plan, the reality is that there are currently 112,000 clinical vacancies and it is a 15-year strategy – it isn’t going to provide an immediate turnaround.

“We urge system leaders to listen to our concerns, realise the potential of acute medicine to support urgent and emergency care and wider NHS recovery and ensure that focus, resource and energy is put into progressing the evidence-based solutions we know will help us to overcome the current challenges.”