The NHS has had it’s hardest difficult winter for a long time- so haow has it coped?
The four hour target to be seen in A&E has been missed in each nation – and that has had a knock-on effect on other parts of the hospital system.
In England all the evidence points to it being the worst winter since the target was introduced at the end of 2004.
The target is officially measured on a quarterly basis and covers the point from arrival to when a patient is discharged, transferred elsewhere or admitted into hospital for further treatment, .
During the last three months of 2014 92.6% were seen within four hours – the worst figure during this whole period.
We will have to wait until the end of March to get the next quarterly data, but performance is on track to be even worse than that.
And NHS England has already admitted the average for the whole of 2014-15 will be below 95% – the first time this has happened for a whole year under the target.
The situation was particularly bad at the turn of the year. A number of hospitals had to declare major incidents, a move normally associated with accidents involving multiple injuries.
To the NHS’s credit, performance did pick up after that point – although not enough to return above the 95% mark.
However, it is worth noting that the UK’s National Health Service has one of the toughest waiting time measures in the world.
Another way to look at it is to see the performance of individual trusts. Take a look at this chart.
England – as the biggest health service and the one that produces the most up-to-date data – has received the most attention.
But the problems have been just as acute elsewhere in the UK. In fact, England could be said to have faired the best.
In January waiting times reached their worst levels in Wales since the current way of recording performance was introduced in 2009.
It got so bad that one police force reported it had had to start taking people to hospital because there weren’t enough ambulances.
Of course, A&Es do not work in isolation and so, unsurprisingly, other parts of the hospital system have experienced problems.
Analysis by the House of Commons Library shows how such pressure points got worse this winter between November and March.
The simple answer is the number of people coming to A&E has gone up. Take a look at these figures.
Between November and February just over 7m visits were made to A&Es in England – 190,000 more than the year before.
The busiest week – the one ending 21 December – saw 446,000 people arrive, up by nearly 10% on the same week the year before and the highest ever recorded.
There were 1.82m emergency admissions – the most complicated cases that cannot be dealt with by A&E – up 51,000 on last year.
But this winter there has also been heated debate about what other factors may have played a role. These have ranged from the new 111 urgent phone service not being as good as it should to problems accessing social care and GPs.
Last spring and summer were also difficult, with the target being missed several times in England.
What is more, Scotland, Northern Ireland and Wales are all still a long way from achieving the target. The A&E story is unlikely to go away just yet.