‘Trolley waits’ in England’s A&E departments hit record high

The number of people enduring “trolley waits” of more than 12 hours in A&E departments has reached a record high.

In November, some 10,646 people waited more than 12 hours in England’s hospitals from a decision to admit them to actually being admitted for treatment.

The figure is up from 7,059 in October and is the highest for any calendar month since records began in August 2010.

Overall, 120,749 people waited at least four hours from the decision to admit to being admitted in November, down only very slightly on the 121,251 in October.

NHS England said last month was the second busiest November on record for A&E, with more than two million patients seen at emergency departments and urgent treatment centres.

It also said staff answered the highest number of 999 calls for any November on record, with an average of around one every three seconds.

Demand for NHS 111 services also remained high, with almost 1.4 million calls answered during November.

The new data showed that the overall NHS waiting list for people needing hospital treatment remains at a record high, with 5.98 million people waiting at the end of October.

Those having to wait more than 52 weeks to start treatment stood at 312,665 in October, up from 300,566 in the previous month and nearly double the number waiting a year earlier, in October 2020, which was 167,067.

A total of 16,225 people in England were waiting more than two years to start routine hospital treatment, up from 12,491 at the end of September and around six times the 2,722 people who were waiting longer than two years in April.

NHS England pointed to data showing that hospitals are struggling to discharge patients who are medically fit to leave owing to problems with social care.

On average, there were 10,500 patients each day last week who no longer needed to be in hospital but who were not discharged that day, NHS England said.

This means that more than one in 10 beds were occupied by patients who were medically fit to leave but could not be discharged.

NHS England figures show that on Sunday December 5, there were 10,123 patients who no longer needed to be in hospital but had not been discharged.

They also show 4,495 patients had been in hospital for more than three weeks and had not yet been discharged despite being medically fit enough to leave.

NHS national medical director Professor Stephen Powis said: “As we head into a very challenging winter, we are working with partners in social care to get as many patients who are fit to do so home for Christmas, which is right for them and their families as well as freeing up beds.”

When it comes to cancer, the latest figures show 227,430 urgent cancer referrals were made by GPs in England in October, up 12% from the 203,904 reported in October last year.

The equivalent figure for October 2019, a non-pandemic year, was 220,304.

Ambulance response times have also improved slightly, though ambulance trusts are still failing to hit targets.

The average response time last month for ambulances in England dealing with the most urgent incidents – defined as calls from people with life-threatening illnesses or injuries – was nine minutes and 10 seconds, against a seven minute target.

There were also slight improvements in the numbers waiting more than six weeks for a key NHS diagnostic test in October.

Some 356,784 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy, compared with 362,367 in October 2020.

Before the pandemic in October 2019 there were 34,812 people waiting.

Overall, the number of people admitted for routine treatment in hospitals in England in October was 255,128 – up 10% from a year earlier (232,466), although this reflects lower-than-usual figures for October 2020, which were affected by the Covid-19 pandemic.

The equivalent figure for October 2019, a non-pandemic year, was 317,992.

Dr Tim Cooksley, president of the Society for Acute Medicine, said: “The current feeling in acute medicine is just how busy it is even without large numbers of people suffering from Covid and there is immense pressure across the whole NHS front line.

“Compared to this time last year it feels far worse and the data shows just how tough things are – the workforce is now struggling not only with the relentless workload but also the uncertainty we all feel.”

Tim Mitchell, vice president of the Royal College of Surgeons of England, said: “Today’s figures are bad news for patients waiting for planned surgery. There are now a record six million people waiting for planned hospital treatment. This includes patients waiting for hip and knee replacements, gallbladder removals and hernia operations.”

Tim Gardner, senior fellow at the Health Foundation, said: “Today’s figures show that the NHS was already facing an exceptionally difficult winter, even before the emergence of the Omicron variant.

“Ambulances and A&E departments are continuing to experience major pressure, while the waiting list for routine hospital treatment has reached another record high.

“While the NHS has little choice but to weather the storm over the coming weeks, a credible strategy for restoring normal levels of service will be vital.

“The NHS recovery plan that has been promised needs to be realistic about the time it could take to bring waiting lists down to manageable levels, and any such plan will need to balance the need to support patients waiting much longer than usual for treatment with the wellbeing of an NHS workforce that is under-resourced, overstretched, and exhausted by the last two years.”