Responding to the publication of NHS England’s combined monthly performance statistics for September 2017, Ruth Thorlby, Assistant Director of Policy at the Health Foundation, said:

‘Planning for winter in the NHS has been underway since the summer, but these statistics do not bode well for either patients or staff. Hospitals had been set a target to treat or discharge 90% of patients going to A&E within four hours by the end of September, but this has been missed. While some progress has been made on reducing the delays in helping people leave hospital safely, it is also well behind the government’s ambitions.

‘The overall numbers of people visiting A&E has dropped slightly, suggesting that efforts to encourage people with minor problems to call 111 or see their GP have had some effect. But what is most worrying is the growth in the number of people who go to A&E, and are unwell enough to need an admission to hospital. If this number continues to rise, the NHS will be facing an extremely difficult winter. At this stage the priority must be to help NHS hospitals take care of these patients safely, which will almost certainly mean providing money for more staff and beds.  

‘This effort should go alongside longer-term solutions to help patients at risk of hospital admissions. For example, Health Foundation research has shown that concerted efforts by GPs, social care staff and the voluntary sector in care homes can prevent unnecessary hospital admissions. But these solutions require a long-term effort and support, to break out of the annual cycle of the NHS just about coping every winter.’

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Further information

The research mentioned above was conducted by the Improvement Analytics Unit, a partnership between NHS England and the Health Foundation. It found that care home residents who received enhanced support were admitted to hospital as an emergency 23% less often than similar residents in other parts of the country.

Summary of key statistics:

  • 1.927m people attended A&E in September 2017, down from 1.952m in September 2016 (1.265m attended major A&Es, down from 1.277m in the same month last year).
  • The number of emergency admissions via major A&Es increased from 345,085 in September 2016 to 356,722 in September 2017. This means that 28.2% of people who attended major A&E in September 2017 needed emergency admission to a hospital bed, up from 27% in September 2016.
  • The Government’s formal mandate to the NHS for 2017/18 set a target that at least 90% of patients should be admitted, transferred or discharged within 4 hours of arrival in A&E by end September. Actual performance was 89.6%.
  • The mandate also set a target to reduce delayed transfers of care to 3.5% of all occupied hospital bed days (approximately 4,080 delays per day) by the end of September 2017/18. The number of delayed transfers per day has fallen since reaching 6,660 in February 2017 (the highest level on record), but was still 5,809 in August 2017.