NHS performance: Fact vs fiction

NHS performance
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FICTION: At the last election in 2017, the Conservatives, led by Theresa May, promised “exceptional healthcare, whenever, wherever, delivered by an NHS with the money, buildings and people it needs”.

The word “exceptional” is not explained, and there is very little in the manifesto on the performance of the NHS – either boasting about achievements or promising improvements.

There is a promise of weekend access to key diagnostic tests, and to discharge of medically fit patients on any day of the week.

On hospital services the manifesto stated: “We will retain the 95% A&E target and the 18- week elective care standard,” and on cancer services “we will deliver the new promise to give patients a definitive diagnosis within 28 days by 2020”.

On mental health the promise was to recruit “up to 10,000 more mental health professionals.”

FACT: None of the commitments in the 2017 Manifesto have been honoured

The NHS now has a major problem with inadequate staff, poorly maintained buildings, and insufficient funding.

Each of these problems feeds through to performance, which is falling back on almost all measures.

Staffing is clearly a factor in the flagging performance in A&E, where the latest figures show 14.6% of people attending A&E in September waited more than four hours to admission or discharge - the worst ever September performance.

So the manifesto commitment to the 95% target is clearly not linked to any commitment to meet it: only TWO of the 119 major A&E departments that submitted information for September this year met the four-hour target.

The 95% target has not been met in England for over five years. 64,921 patients who needed to be admitted spent over four hours on trolleys in September waiting for a bed – 46% higher than the same month last year.

This followed the staggering increase of 1,400% in the numbers of so-called “trolley waits” from August 2010 to August 2019.

What is alarming is that these incredibly high levels of pressure are continuing in our hospitals right through what used to be relatively quiet summer months.

455 patients waited over 12 hours on a trolley in September, THREE TIMES the number last year.

The increased delays flow from a combination of rising use of A&E (and limited availability of alternative support) with a hefty reduction in front-line beds and a lack of services outside hospital.

Numbers of the most serious “Type 1” emergency patients attending A&E in August have increased by 21% since 2010, while the population is only estimated to have increased by around 6.6%.

Total emergency admissions to hospital, which include urgent referrals by GPs, have risen by 28%, rising faster than general attendances at A&E.

The Manifesto commitment to speedy cancer treatment is grimly ironic given that the 62-day target to start cancer treatment has only been met once in five years, and more than one in five wait more than two months for their first treatment.

The Manifesto commitment to the 18-week target for elective treatment is no more convincing, given that the proportion of the 4.5 million waiting list who have waited more than 18 weeks has risen to 15% -- the highest since 2008.

And never mind promises on weekend access: the diagnostic waiting time target has not been met since November 2013.

No wonder Matt Hancock is looking for ways of scrapping the targets an under-funded NHS can’t hit.


the increase in numbers of hospital “trolley waits” in A&E since 2010
the increase in 12 hr waits for a hospital bed since 2010
number of patients waited over 4 hours for a bed during the month, September 2019
patients in England now on waiting list for treatment
1 in 5
cancer patients (21.5%) has to wait up to 2 months for hospital treatment
of hospital trusts miss target to treat cancer patients within 2 months of referral


This article was originally published in Health Campaigns Together Election Special newspaper.

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