Hospitals prepare for winter rush

Denis Campbell, health correspondent 

Hospitals are facing growing problems as winter pressures loom, with more missing the A&E treatment target, more patients being admitted as an emergency and bed closures on the increase.

NHS data detailing hospitals' performance over the past week shows that hospitals across England failed to treat 95% of A&E patients within four hours, the second successive week that has happened.

Overall 94.8% of patients were seen within four hours. But in all 97 hospital trusts, about 60% of the total, breached the target. Mid Staffordshire NHS Foundation Trust recorded the worst figure, at 76%, while at Portsmouth Hospitals NHS Trust it was 78.1%.

In another worrying development, norovirus, the winter vomiting bug, has started to lead to beds being closed just when hospitals need them most.

NHS England said that while "there are no major problems...there are signs of winter pressures, particularly with increasing beds closed due to norovirus-like symptoms."

The number of operations that were cancelled at the last minute rose to 1,253 in the week ending Sunday, 15 December from 1,196 in the same week in 2012. A total of 8,089 planned procedures have had to be postponed since 4 November.

The number of beds unavailable every day last week due to what the NHS calls "delayed transfers of care" - difficulties getting patients discharged, often because social care is not in place to help them - also rose year-on-year, from 2,483 in 2012 to 2,994 last week.

In all 105,460 patients had to be admitted to hospital as an emergency via A&E last week, slightly fewer than the week before but more than the same week in 2012. Dame Barbara Hakin, NHS England's deputy chief executive, said that "emergency admissions remain very high."

Andy Burnham, the shadow health secretary, said the total was the highest since January 2012 and was "a clear sign that too many frail, older people are struggling to cope because of the loss of care suport at home [after] severe cuts to social care."

He accused health secretary Jeremy Hunt of demonstrating "complacency [that] is a danger to patients" for not acknowledging that "A&E departments are in danger of being overwhelmed, and this is before the worst of the winter pressure has even started."

The number of patients having to wait over four hours on a trolley before being admitted rose last week to 3,961, the highest total since April, Burnham added.

Hakin admitted that "delayed transfers continue to run higher than the equivalent period last winter [and that] remains a concern". Local NHS bosses had been asked to "redouble their efforts on this issue so as to spot issues early and take action", she added.

However, more positively, the number of occasions on which ambulances were delayed in handing over a patient to A&E staff has fallen 30% year-on-year, Hakin added, though still happened 4,913 times in the last week and has occured 28,067 times since 4 November.

A spokeswoman for Hunt said: "Labour's desperate attempts to turn winter pressures into a political football are disingenuous. The NHS has never met its A&E target at this time of year, including when Andy Burnham was health secretary, but thousands more patients are being seen within four hours than they were on his watch."