Steep rise in summer A&E admissions amid record attendances

Aug 9, 2019

  • A&E attendances hit record 2.27 million in July 2019
  • Admissions also rocket and four-hour performance falls again
  • Four-hour target has not been hit for exactly four years

Admissions at major NHS emergency departments have risen six per cent in 12 months as total attendances hit 2.27m last month – the highest level since records began in 2010.

NHS England’s official monthly data lays bare the NHS’s inability to get on top of its significant demand problems with both admissions and attendances rising and performance against the four-hour target falling in July.

The fall against the four-hour target comes with 14 trusts trialling new emergency care metrics as part of the controversial clinical standards review which could see the flagship target axed by April.

The 2.27 million attendances was 4 per cent increase on July 2018. Of these, attendances at type 1 A&E departments were 3.7 per cent higher and type 3 departments were 4.3 per cent higher than July 2018.

There were 554,069 total emergency admissions in July – 4.6 per cent higher than the same month last year. This means emergency admission have grown 3.4 per cent in the last three months and 5.3 per cent over the last 12 months.

Emergency admissions for just major type 1 A&E departments saw the sharpest rise – up 4.7 per cent compared to July 2018. This means emergency admissions have grown by 4.1 per cent over the last three months and 6.1 per cent over the last 12 months.

The NHS did manage to treat a record number of patients – 1.8 million – within four hours, a 0.6 per cent increase on the equivalent figure for July 2018.

Despite the recording breaking effort, performance against the four-hour target dropped again – meaning the four-hour target has now not been met for exactly four years.

Some 86.5 per cent of patients were seen within four hours in all A&E departments this month compared to 86.4 per cent in June 2019 and 89.4 per cent in July 2018.

Type one performance fell to 78.9 per cent, compared to 78.8 per cent in June 2019 and 83.3 per cent in July 2018.

The Nuffield Trust said the hot weather was a factor and also raised concerns about the unusually high level of trolley waits for a summer month.

Chief executive Nigel Edwards said: “The soaring temperatures in July have taken their toll on patients and staff, with a record number of people turning up to A&E last month.

“The number of people waiting over four hours on trolleys to be admitted was also unusually high for summer at over 57,000 – a figure that would have once been unthinkable, even in the depths of winter.

“And it’s not just about A&E – sadly these figures show relentless pressure throughout the whole system. More than 1 in 10 people on the list for planned treatment are now waiting over 18 weeks, the worst level since January 2009, and the key two-month cancer treatment target now hasn’t been met in three and a half years.”

Health Foundation senior policy fellow Tim Gardner said: “The new prime minister has identified reducing NHS waiting times as one of his key priorities, but today’s statistics show there is a mountain to climb. Hospitals are struggling to cope with the demand of emergency admissions which have continued to grow year on year, while people are waiting longer for planned surgery.”

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