Surge in A&E patients seen just before deadline expires

8:00am Friday 14th February 2014

By Oliver Evans

NEW figures have revealed a surge in accident and emergency patients being seen minutes before a waiting time target expires.

The figures have revealed a sharp rise in the number of people seen shortly before the target is up at Oxford’s John Radcliffe Hospital and Banbury’s Horton Hospital.

Emergency departments must ensure at least 95 per cent of people are discharged, admitted or transferred within four hours.

But hospital bosses have warned many are going to A&E with less serious conditions and could be seen by other NHS services, causing long delays.

Of the 116,700 seen at county A&E departments last year, some 18,855 were dealt within three hours 51 minutes to four hours since arriving.

This was up from 8,755 seen from three hours 41 minutes to three hours 50 minutes and 6,029 in the nine minutes before.

It means some 16 per cent of patients were seen in the last nine minutes, up from 10.3 per cent in the previous year.

Most of these – 57 per cent – were admitted while 15 per cent were discharged with no follow-up, and 12 per cent asked to see their GP.

Though a similar surge was seen across England, just eight per cent waited until the last nine minutes.

Larry Sanders, chairman of Healthwatch, the county’s official NHS watchdog, said: “It is definitely a distortion.

“The four-hour limit has obviously done some good. On the other hand, this kind of abstract target leads to unwanted results.”

He said of those who wait longest: “What I guess happens is people who are left like that are people who the staff can’t make up their minds about.”

The figures – for the year from April 2012 – show the busiest time was about midday, when 7,292 attended.

Some 9,330 waited up to an hour; 20,583 one to two hours; 27,941 two to three hours; 49,567 three to four hours and 9,279 four hours and over.

The longest average waits – about three hours and 20 minutes – were around midnight and the lowest – two-and-a-half hours – at around 8am.

The trust has only hit the 95 per cent target for two weeks since October 20.

Oxford East Labour MP Andrew Smith said: “There is always a danger that focusing on any single target will skew behaviour, but assuming it’s all being recorded accurately this does show the efforts being made to achieve the maximum four-hour wait target.

“The key clinical judgment here is ensuring that those needing the most urgent attention are getting it, which is not something measured in these figures.”

A trust spokesman said: “Patients attending A&E will be assessed, treated and either discharged home or admitted to a ward within four hours.

“There may also be a wait for blood test results and diagnostic imaging and this can sometimes take a bit of time and, at very busy periods, patients are more likely to wait the full four hours.

“Patients will always be seen based on their clinical priority and need.”

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