A&E waiting times hit eight-year high as NHS struggles to meet productivity challenge

Published on Thursday, 31 May 2012 09:45
Posted by Scott Buckler

The proportion of patients spending more than four hours in A&E has increased by more than a quarter over the last year, reaching its highest level since 2004, according to the latest quarterly monitoring report on NHS performance published by The King’s Fund

A&E waiting times increased sharply in the last two quarters of 2011/12, despite the Prime Minister’s pledge in June last year that they would remain low. Although at a national level, A&E waits still remain within the government’s target range that no more than 5 per cent of patients should wait more than four hours, 48 NHS providers breached this threshold, compared to 18 in the second quarter. This reflects growing pressures on the hospital sector and coincides with emerging evidence of increases in ‘trolley waits’ as some hospitals struggle to find beds for patients.

The report also found that 40 per cent of NHS organisations failed to meet productivity targets in 2011/12, based on the findings of an expanded survey of 60 NHS finance directors. This will be a significant concern as last year was the first in a four-year spending squeeze, during which the NHS needs to find £20 billion in productivity improvements.

This quarter’s report looks back at how the NHS performed during the first year of the spending squeeze. It shows that it is performing well against a number of key indicators.

  •     Waiting times for hospital treatment are stable, with the proportion of inpatients waiting more than 18 weeks falling over the last 12 months, while outpatient waits remain static.
  •     C difficile and MRSA infections in hospitals fell by 33 cent and 14 per cent respectively during 2011/12, continuing the downward trend of recent years.
  •     The proportion of patients waiting more than six weeks for diagnostic tests fell to its lowest level since the last General Election.


Our survey of NHS finance directors indicates that the NHS has ended 2011/12 in a healthy financial position, with just four forecasting a deficit in their organisation – in line with national figures estimating a surplus of £1.5 billion across the NHS as a whole. However, this masks significant financial challenges in some areas, with recent figures showing that 31 hospitals received ‘bail out’ funding of £414 million in 2011/12, an increase on previous years.

The main findings from our survey of finance directors were:

  •     nearly half (28) said their organisations met their cost improvement targets in 2011/12, with two-fifths (23) failing to meet their targets and one-tenth (7) exceeding them
  •     more than half (32) were pessimistic about the financial prospects for their health economy over the next year, with less than a quarter (14) optimistic about this.
  •     35 said their organisations plan to reduce staff numbers, with the 28 able to quantify their plans identifying nearly 4,200 job losses – if replicated across the NHS, this would add up to the biggest fall in staff numbers in more than a decade.


John Appleby, Chief Economist at The King’s Fund said: ‘Overall, the NHS continues to perform well, despite the spending squeeze. However, this masks growing pressures in hospitals and significant performance issues in some NHS organisations. Given the strength of the political commitment to keep waiting times low, the steep rise in A&E waits will be a concern for the government. The productivity challenge will only get harder, so evidence that large numbers of  NHS organisations failed to meet their productivity targets last year does not bode well.’

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