Report: hospital waiting times highest for three years

Waiting times for hospital treatment have reached their highest level for three years as the NHS spending squeeze begins to bite, according to a new quarterly monitoring report published by The King’s Fund.

The new report - How is the NHS performing? the first of a regular update that will be published by the Fund every quarter - provides a snapshot of the state of the NHS by combining analysis of key performance data with the views of a panel of NHS finance directors.

It highlights the pressure building within the health system as budgets are squeezed and the NHS struggles to deliver productivity improvements. Among the key findings:

· Most of the finance directors surveyed are already warning that they are unlikely to meet productivity targets in 2011/12.

· The panel outlined a range of plans for making services more efficient but nearly half identified ward closures and cuts in services among the main ways of meeting productivity targets in their area.

· In February 2011, nearly 15 per cent of hospital inpatients waited over 18 weeks for treatment - the highest level since April 2008.

· The proportion of patients waiting more than four hours in A&E rose sharply at the end of 2010, reaching its highest level since 2004/05.

· The proportion of patients waiting more than six weeks for diagnostic services fell back in February, reversing a steady increase since June 2010.

· Levels of hospital acquired infections have fallen to their lowest level in recent years, while delays in transferring patients out of hospital remain stable.

With the NHS needing to find £20 billion in productivity improvements by 2015, many of the panel of 26 NHS finance directors surveyed stressed the difficulty of continuing to manage demand for services, meet targets and maintain quality with the financial squeeze beginning to bite.

While most were confident they had met their productivity targets for 2010/11, over two-thirds said they may not meet their targets for 2011/12.

Most of the panellists called on the government to be more realistic about the challenges involved in finding the savings needed.

The panel highlighted a range of plans for improving productivity in their area including workforce changes, redesigning services to improve efficiency and reducing lengths of stay in hospital.

Only six identified back office efficiencies among the main ways productivity targets will be met, with a number sceptical about the savings to be made through this route.

12 of the 26 panellists identified closing hospital wards and reducing services among the main ways that savings will be delivered in their area.

The analysis of key performance data highlights a steady increase in waiting times for hospital treatment since waiting times targets were relaxed in June 2010.

In February 2011, nearly 15 per cent of inpatients waited more than 18 weeks before being admitted to hospital - the highest proportion since April 2008.

The latest data for A&E waits also shows a sharp increase in the third quarter of 2010/11, with 3.5 per cent of patients waiting for more than four hours, compared to 2 per cent the previous quarter.

While these rises in part reflect seasonal factors, they are not explained by this alone.

The proportion of patients waiting more than six weeks for diagnostic services fell back to 1.46 per cent in February 2011.

This reverses a steady increase since June 2010, although this is still twice the level recorded in February 2010.

Levels of hospital acquired infections continued to fall, with 711 cases of "C difficile" and 46 cases of MRSA recorded in February 2011.

This represents a reduction of over two-thirds since hospital acquired infections peaked in 2008.

The number of delayed transfers of care - patients unable to leave hospital because appropriate care in the community has not been arranged - fell slightly in March 2011.

Professor John Appleby, chief economist at The King’s Fund, said: "This report will provide a regular health check on the state of the NHS as it comes to terms with the new financial climate and implements the government’s reforms.

"It highlights significant concern among NHS finance directors - who are well placed to report on the stresses in the system - about the prospects for the year ahead.

"With hospital waiting times rising, the NHS faces a considerable challenge in maintaining performance as the financial squeeze begins to bite."

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