More than a third of A&E patients were not treated within four hours at England’s worst-performing casualty unit last month, NHS figures show.

Norfolk and Norwich University Hospitals processed 62.9 per cent of its patients within the target time – the lowest figure recorded in the country.

Five other trusts, including ones in Birmingham, Lincolnshire and Leicestershire also dropped below the 70 per cent mark in October. 

Data from the health service yesterday revealed last month was the worst on record for emergency department performance.

Across England one in six patients needing urgent care had to wait more than four hours for it, as only 83.6 per cent of people were treated within the target time.

Experts warned the NHS, already struggling from a busy summer, was heading for one of the ‘bleakest winters’ in its history. 

Hospital bosses say huge increases in patient numbers are clogging up their A&E departments, among them patients who don’t need to be there and who face long waits because they aren’t urgent cases.

NHS statistics have revealed a geographical breakdown of how A&E departments are faring across the country – some in Norfolk, Lincolnshire and Shropshire recorded the worst figures for England

NHS statistics have revealed a geographical breakdown of how A&E departments are faring across the country – some in Norfolk, Lincolnshire and Shropshire recorded the worst figures for England

Yesterday the general secretary of the UNISON union, Dave Prentis, said: ‘Patients left in agony on trolleys for hours and poorly visitors waiting for hours in A&E, forced to sit on floors because of a lack of chairs, has become the new normal.

‘Years of underfunding and an endless staffing crisis show the Conservatives are simply not fit to run our NHS.

‘These are the worst ever A&E figures yet the winter has barely begun. It’s a shocking state of affairs and should be of huge concern to every one of us.’

The statistics showed people attended A&E departments 2,170,510 times in October – 70,016 visits per day – a 4.4 per cent rise from October last year.

The proportion of these seen within the NHS’s four-hour target time ranged across the country, from a low of 62.9 per cent to 97.8 per cent. 

Behind Norfolk and Norwich University Hospitals was United Lincolnshire Hospitals (64.2 per cent).

This was followed by Shrewsbury and Telford (64.4 per cent), University Hospitals Birmingham (66 per cent) and Stockport (66.8 per cent).

At the other end of the scale among hospitals with comparable patient numbers came Northumbria Healthcare (95.7 per cent).

It was followed by Barnsley Hospital (95.2 per cent), Homerton University Hospital in London (94 per cent), Newcastle upon Tyne Hospitals (93.6 per cent) and Yeovil Distric Hospital (92.4 per cent).

WHAT IS THE NHS’S FOUR-HOUR A&E TARGET?

The NHS’s four-hour A&E target is one set out in the NHS constitution which dictates 95 per cent of all emergency patients in England should be admitted to hospital or discharged within four hours of arriving.

Hospitals’ performance against this measure has been tracked for more than a decade.

At a national level the NHS hasn’t hit the 95 per cent target since July 2015, when it was 95.2 per cent.

Since then there has been a steady decline to October 2019’s record low of 83.6 per cent.

That low meant that one out of every six people who went to A&E in that month waited there for more than four hours – more than 320,000 people. 

The woeful figures come at a time when the NHS is trying to scrap the four-hour target completely.

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Unable to meet the ambitious 95 per cent, the health service is now trying to switch to a system which doesn’t measure waiting times against a set benchmark but simply tries to treat the more urgent cases faster and loosens the limit for less serious patients.

A total of 40 hospitals’ performances were above average, while 77 were below. One – Whittington Health in London – was the same as the national figure.

The reasons why some hospitals’ performances are worse than other can depend on a number of things. 

NHS funding, the ages and general health of local people and how populations or demand have changed since hospitals were built may all play a role.

Statistics show that as people are living longer lives and conditions like obesity and diabetes are on the rise, increasing numbers of patients have more than one serious illness which can mean it’s more difficult to treat them. 

The director of operations at United Lincolnshire Hospitals NHS Trust, Simon Evans, said: ‘Our A&E performance is not where we want it to be and we would like to apologise for this. 

‘Over recent months we have seen a significant increase in the number of very poorly patients attending at our A&Es, as well as cases of the winter vomiting bug norovirus. 

‘This has coincided with a reduction in the number of patients being discharged from our hospitals, which has unfortunately resulted in long delays for some of our patients in A&E. 

‘If someone comes to A&E and it is not an emergency, they may have a long wait as we will always prioritise the sickest patients. Please consider if you could be helped by visiting your local pharmacy, by contacting your GP, or attending an urgent care centre.’

Just 83.6 per cent of patients were seen within four hours in October, a record low which meant 320,000 people sat for longer while medics decided what to do with them

Just 83.6 per cent of patients were seen within four hours in October, a record low which meant 320,000 people sat for longer while medics decided what to do with them

WHICH HOSPITAL TRUSTS TREATED THE MOST PATIENTS WITHIN FOUR HOURS? 

  1. Northumbria Healthcare (95.7%)
  2. Barnsley (95.2%)
  3. Homerton University Hospital, London (94%)
  4. The Newcastle Upon Tyne Hospitals (93.6%)
  5. Yeovil District (92.4%)
  6. Birmingham Women’s And Children’s (92.2%)
  7. Salisbury (91.8%)
  8. Sherwood Forest (91.5%)
  9. Harrogate And District (90.4%)
  10. Doncaster And Bassetlaw Teaching Hospitals (90.3%)

NB: Sheffield Children’s Hospital excluded from comparison

WHICH HOSPITAL TRUSTS TREATED THE FEWEST PATIENTS WITHIN FOUR HOURS? 

  1. Norfolk And Norwich University Hospitals (62.9%)
  2. United Lincolnshire (64.2%)
  3. Shrewsbury And Telford (64.4%)
  4. University Hospitals Birmingham (66%)
  5. Stockport (66.8%)
  6. University Hospitals Of Leicester (67%)
  7. Bolton (70%)
  8. Hull University Teaching (70.60%)
  9. Isle Of Wight (70.90%)
  10. Sandwell And West Birmingham (71.7%)

 Source: NHS England performance statistics 

Nigel Lee, chief operating officer of Shrewsbury and Telford Hospital NHS Trust, said: ‘In the three months from July to September this year we saw almost 39,000 people come through the doors of our emergency departments.

‘[This is] a rise of more than 4,100 on the same period in 2018. That is the equivalent of an additional 45 people a day, every day, for three months.

‘That trend continued in October, when we saw 12,399 ED attendances – 1,135 more than in October 2018 – with 3,985 ambulance arrivals – 621 more than this time last year, and we know that this is a pattern being repeated across the country. 

‘More complex cases have more complex needs which take longer to meet, but we will not compromise on patient care.’

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A spokesperson for Norfolk and Norwich University Hospitals NHS trust said the trust was opening a new ward next year to cope with demand.

They said: ‘The last few months have been particularly challenging with high numbers of emergency attendances and an increase in admissions. 

‘Our emergency and urgent care staff are seeing on average more than 400 patients a day and are doing the best they can to assess and treat patients as quickly as possible.’ 

FULL LIST OF HOSPITAL TRUSTS’ A&E PERFORMANCE FIGURES FOR OCTOBER 2019 (Source: NHS England) 
Name of hospital trust Percentage of A&E patients
treated, discharged
or admitted within 4 hours or less
Norfolk And Norwich University Hospitals NHS Foundation Trust 62.9%
United Lincolnshire Hospitals NHS Trust 64.2%
Shrewsbury And Telford Hospital NHS Trust 64.4%
University Hospitals Birmingham NHS Foundation Trust 66%
Stockport NHS Foundation Trust 66.8%
University Hospitals Of Leicester NHS Trust 67%
Bolton NHS Foundation Trust 70%
Hull University Teaching Hospitals NHS Trust 70.6%
Isle Of Wight NHS Trust 70.9%
Sandwell And West Birmingham Hospitals NHS Trust 71.7%
Wye Valley NHS Trust 72.1%
King’s College Hospital NHS Foundation Trust 72.2%
Royal United Hospitals Bath NHS Foundation Trust 72.4%
Wirral University Teaching Hospital NHS Foundation Trust 72.7%
Barking, Havering And Redbridge University Hospitals NHS Trust 72.9%
Northampton General Hospital NHS Trust 73%
Bradford Teaching Hospitals NHS Foundation Trust 73.3%
The Princess Alexandra Hospital NHS Trust 74.2%
St Helens And Knowsley Teaching Hospitals NHS Trust 74.3%
Dartford And Gravesham NHS Trust 74.7%
Weston Area Health NHS Trust 74.7%
County Durham And Darlington NHS Foundation Trust 75%
Mid Cheshire Hospitals NHS Foundation Trust 75.5%
George Eliot Hospital NHS Trust 75.7%
North West Anglia NHS Foundation Trust 75.8%
Medway NHS Foundation Trust 76.4%
Hampshire Hospitals NHS Foundation Trust 76.4%
Worcestershire Acute Hospitals NHS Trust 76.5%
University Hospitals Of North Midlands NHS Trust 76.7%
The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust 77.4%
Mid Essex Hospital Services NHS Trust 77.4%
University Hospitals Of Derby And Burton NHS Foundation Trust 77.6%
Royal Surrey County Hospital NHS Foundation Trust 77.8%
South Tyneside And Sunderland NHS Foundation Trust 78.3%
Brighton And Sussex University Hospitals NHS Trust 78.4%
Ashford And St Peter’s Hospitals NHS Foundation Trust 78.5%
Lancashire Teaching Hospitals NHS Foundation Trust 78.7%
Northern Lincolnshire And Goole NHS Foundation Trust 78.7%
Chesterfield Royal Hospital NHS Foundation Trust 79%
East Cheshire NHS Trust 79.3%
Royal Free London NHS Foundation Trust 79.7%
North Cumbria Integrated Care NHS Foundation Trust 79.9%
North Bristol NHS Trust 80%
Warrington And Halton Hospitals NHS Foundation Trust 80%
York Teaching Hospital NHS Foundation Trust 80.4%
East Kent Hospitals University NHS Foundation Trust 80.4%
James Paget University Hospitals NHS Foundation Trust 80.6%
Great Western Hospitals NHS Foundation Trust 80.6%
University Hospitals Coventry And Warwickshire NHS Trust 80.6%
Gloucestershire Hospitals NHS Foundation Trust 80.6%
Royal Devon And Exeter NHS Foundation Trust 80.7%
University College London Hospitals NHS Foundation Trust 80.8%
Taunton And Somerset NHS Foundation Trust 80.8%
Countess Of Chester Hospital NHS Foundation Trust 81.1%
East Sussex Healthcare NHS Trust 81.2%
University Hospitals Of Morecambe Bay NHS Foundation Trust 81.2%
Manchester University NHS Foundation Trust 81.5%
Buckinghamshire Healthcare NHS Trust 81.5%
The Dudley Group NHS Foundation Trust 81.6%
Southend University Hospital NHS Foundation Trust 81.6%
Pennine Acute Hospitals NHS Trust 81.7%
Oxford University Hospitals NHS Foundation Trust 81.9%
Royal Berkshire NHS Foundation Trust 82.1%
University Hospital Southampton NHS Foundation Trust 82.1%
Walsall Healthcare NHS Trust 82.3%
University Hospitals Bristol NHS Foundation Trust 82.4%
The Hillingdon Hospitals NHS Foundation Trust 82.6%
The Royal Bournemouth And Christchurch Hospitals NHS Foundation Trust 82.7%
Salford Royal NHS Foundation Trust 82.7%
North Middlesex University Hospital NHS Trust 82.7%
Barts Health NHS Trust 82.7%
Torbay And South Devon NHS Foundation Trust 82.7%
Sheffield Teaching Hospitals NHS Foundation Trust 82.9%
East Lancashire Hospitals NHS Trust 83.1%
West Hertfordshire Hospitals NHS Trust 83.1%
Liverpool University Hospitals NHS Foundation Trust 83.1%
St George’s University Hospitals NHS Foundation Trust 83.2%
England 83.6%
Whittington Health NHS Trust 83.6%
Lewisham And Greenwich NHS Trust 83.8%
Leeds Teaching Hospitals NHS Trust 83.8%
Croydon Health Services NHS Trust 84.1%
Blackpool Teaching Hospitals NHS Foundation Trust 84.1%
Calderdale And Huddersfield NHS Foundation Trust 84.2%
East Suffolk And North Essex NHS Foundation Trust 84.3%
Guy’s And St Thomas’ NHS Foundation Trust 84.8%
London North West University Healthcare NHS Trust 84.9%
Milton Keynes University Hospital NHS Foundation Trust 85%
Southport And Ormskirk Hospital NHS Trust 85.2%
Airedale NHS Foundation Trust 85.4%
East And North Hertfordshire NHS Trust 85.8%
The Royal Wolverhampton NHS Trust 85.9%
Northern Devon Healthcare NHS Trust 86.1%
Wrightington, Wigan And Leigh NHS Foundation Trust 86.1%
Epsom And St Helier University Hospitals NHS Trust 86.3%
Tameside And Glossop Integrated Care NHS Foundation Trust 86.4%
Kingston Hospital NHS Foundation Trust 86.6%
Alder Hey Children’s NHS Foundation Trust 86.9%
Royal Cornwall Hospitals NHS Trust 87%
Bedford Hospital NHS Trust 87.1%
Surrey And Sussex Healthcare NHS Trust 87.2%
South Tees Hospitals NHS Foundation Trust 87.7%
Western Sussex Hospitals NHS Foundation Trust 88%
Maidstone And Tunbridge Wells NHS Trust 88.9%
South Warwickshire NHS Foundation Trust 89%
Basildon And Thurrock University Hospitals NHS Foundation Trust 89.8%
Gateshead Health NHS Foundation Trust 89.8%
Dorset County Hospital NHS Foundation Trust 90.1%
Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Trust 90.3%
Harrogate And District NHS Foundation Trust 90.4%
Sherwood Forest Hospitals NHS Foundation Trust 91.5%
Salisbury NHS Foundation Trust 91.8%
Birmingham Women’s And Children’s NHS Foundation Trust 92.2%
Yeovil District Hospital NHS Foundation Trust 92.4%
The Newcastle Upon Tyne Hospitals NHS Foundation Trust 93.6%
Homerton University Hospital NHS Foundation Trust 94%
Barnsley Hospital NHS Foundation Trust 95.2%
Northumbria Healthcare NHS Foundation Trust 95.7%
Sheffield Children’s NHS Foundation Trust 97.8%
Cambridge University Hospitals NHS Foundation Trust N/A – trialing new system
Luton And Dunstable University Hospital NHS Foundation Trust N/A – trialing new system 
West Suffolk NHS Foundation Trust N/A – trialing new system 
Chelsea And Westminster Hospital NHS Foundation Trust N/A – trialing new system 
Imperial College Healthcare NHS Trust N/A – trialing new system 
Kettering General Hospital NHS Foundation Trust N/A – trialing new system 
Nottingham University Hospitals NHS Trust N/A – trialing new system 
Mid Yorkshire Hospitals NHS Trust N/A – trialing new system 
North Tees And Hartlepool NHS Foundation Trust N/A – trialing new system 
The Rotherham NHS Foundation Trust N/A – trialing new system 
Frimley Health NHS Foundation Trust N/A – trialing new system 
Portsmouth Hospitals NHS Trust N/A – trialing new system 
Poole Hospital NHS Foundation Trust N/A – trialing new system 
University Hospitals Plymouth NHS Trust N/A – trialing new system 
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