A third of A&E patients are waiting longer than four hours at England’s worst-performing casualty

Only a third of patients visiting England’s worst-performing A&E are being treated within four hours.

And just six hospital trusts in the entire country hit the target in February, dubbed the ‘toughest month ever for the NHS’. 

On average, English hospitals only managed to see 84.2 per cent of A&E patients within the four-hour time limit – the lowest figure ever. 

Health leaders have today slammed the figures, analysed by MailOnline, as being ‘dire’ and ‘a catastrophe’.

They come amid controversial plans announced by the NHS which could see the four-hour target scrapped completely because hospitals keep failing to meet it.

The Princess Alexandra Hospital NHS Trust in Harlow, Essex, had the worst performing A&E in February, managing to treat, admit or discharge just 64 per cent of its patients in four hours

The Princess Alexandra Hospital Trust in Harlow, Essex, cared for just 64 per cent of its A&E patients within the NHS time target last month.

And all but six of the 135 hospital trusts in England fell short of the health service target of treating or discharging 95 per cent of patient in four hours.

The British Medical Association this month said ‘it’s difficult to imagine the NHS in a much worse state’.

NHS Providers, a trade association for hospital trusts, recently posted a comment on its website saying February was the ‘toughest month to date’ for the health service.

In the final week of January overloaded hospital beds were the busiest they had been all winter, with 95 per cent of overnight beds filled.

‘These A&E figures show the problem isn’t bad management or lazy doctors,’ the vice-president of the Royal College of Emergency Medicine, Chris Moulton, told MailOnline. 

‘It’s an endemic problem. It’s a catastrophe.

‘Four hours is a reasonable time for patients to be seen. It’s certainly reasonable for those who are very ill and, if you’re not very ill, you don’t want to be in A&E.

‘The population keeps getting bigger and there are something like 200 more people over the age of 85 every day. This is absolutely going to get worse.’

Recently announced plans could see the four-hour target scrapped in favour of new ways of measuring how long it takes for people to be seen. 

These will be trialled in the next few months and potentially rolled out later in the year, according to NHS England. 

Mr Moulton added: ‘If you’re in the Olympics and you can’t do the high jump you don’t ask to lower the bar. Hospitals need more capacity to meet the target. 

NHS A&E departments try to see 95 per cent of their patients within four hours but the health service as a whole hasn't hit the benchmark for an entire year since 201

NHS A&E departments try to see 95 per cent of their patients within four hours but the health service as a whole hasn’t hit the benchmark for an entire year since 2014

‘Changing the target isn’t going to make waits any shorter and it won’t improve anything for patients or staff.

‘It will camouflage the very long waits and take the heat off the NHS for a while by making it harder to compare with previous years.’        

NHS UNVEILS PLANS WHICH COULD REPLACE FOUR-HOUR A&E WAIT LIMIT 

NHS England this week began the process of scrapping the four-hour maximum A&E wait target to replace it with new ones. 

In place of its infamous four-hour target, the NHS is now trialling seeing the most seriously ill patients – strokes and heart attacks, for example – within one hour.

Those with less serious conditions, meanwhile, will have to wait longer, and new targets will be drawn up after pilots at around a dozen hospitals later this year. 

Having failed to hit the four-hour benchmark for nearly four years in a row – it was last met in July 2015 – the NHS is now rewriting its own goals.

‘Now is the right time to look again at the old targets,’ the NHS’s medical director said. 

This is despite past warnings from emergency medicine experts that scrapping the target could put patient safety at risk. 

In January, Dr Taj Hassan, president of the Royal College of Emergency Medicine (RCEM) said: ‘Scrapping the four-hour target will have a near-catastrophic impact on patient safety in many emergency departments that are already struggling to deliver safe patient care in a wider system that is failing badly.’

Removing the target could wipe the NHS’s slate clean in one respect, making A&E data for the past 15 years difficult to compare with how hospitals perform in future.

And one branch of the health service, NHS Providers, has already admitted it may look like bosses are ‘moving the goalposts’.

A&E departments in February managed to process six per cent fewer patients than they did last year, which was considered the height of the NHS’s ‘worst ever winter’. 

Ten of them fell to below the 75 per cent mark, meaning a quarter of their patients were waiting more than four hours to be seen.

Labour’s Shadow Health Secretary, Jonathan Ashworth, said: ‘It really is dire that so many hospitals are failing the four hour A&E target and patients are left to endure longer waits in pain and distress. 

‘The simple truth is year after year of Tory underfunding and cutbacks have pushed A&E departments to the brink.’ 

The Princess Alexandra Hospital Trust was comfortably the worst, followed by Nottingham University Hospitals NHS Trust, which treated 68.3 per cent in time.

Hospital trusts in Shrewsbury and Telford, Stockport, Salford, West Hertfordshire, Worcestershire, Bradford, Lincolnshire and Plymouth all left more than a quarter of their patients waiting for more than four hours.  

The Princess Alexandra Hospital Trust serves a population of around 350,000 people in Harlow and the surrounding area.

It was rated Requires Improvement – the second lowest out of four possible scores – by the Care Quality Commission in its latest report in March last year.

The report warned the hospital, built in the 1960s, is showing ‘very significant signs of age’ and needs £50million worth of work doing to it.  

In 2016 it paid a £1.8million fine for making patients wait more than a year for treatment – the NHS says no patients should have to wait more than 52 weeks. 

Other February statistics slammed as ‘shameful’ by the Shadow Health Secretary, Jonathan Ashworth, showed waits for cancer treatment are longer than ever, with record numbers of people waiting more than a month to start therapy.

And the NHS missed its target to treat people within two months of a doctor’s referral for the 37th month in a row.

The waiting list for all types of treatment rose to 4.16million people – second only to 4.18m in October last year.

More than 220,000 of those people had been waiting for six months or more, and 36,000 of them for at least nine months. 

An NHS England spokesperson said: ‘NHS staff across the country have been working incredibly hard throughout winter to provide the best care for patients and despite significant increases in demand, almost a quarter of a million more people were seen and treated within four hours in A&E this winter compared to last year.’

Rachel Power, chief executive of the Patients Association, told MailOnline: ‘These figures are a huge concern, particularly when you consider the relatively mild winter we have experienced this year. 

‘It’s a sad indictment of the state that our health service has been allowed to fall into that thousands of patients needing urgent medical help face the awful prospect of being left stranded in cramped corridors or on hospital trollies, waiting for a hospital bed to become available.

‘These figures are also important considering the NHS’s plans to revise targets for A&E patients to be treated within four hours.’

Dr Simon Walsh, the British Medical Association’s emergency medicine lead, said: ‘These figures show the worrying scale of pressures on emergency departments across the country as inability to meet the four-hour target has now become the norm and not the exception.

‘Despite a relatively mild winter and lower cases of influenza, many trusts are regularly reporting performance figures significantly below the 95 per cent target. 

‘A major factor behind this relentless decline in performance is the excessive occupancy that many hospitals are running at; often exceeding levels of capacity at which it is accepted that performance will inevitably decline and even reaching levels where safe patient care is put at risk.

‘This is both concerning for patients who are stuck in overcrowded emergency departments waiting for beds to be available on the wards and concerning for the staff who are working around the clock in incredibly challenging circumstances.’ 

John O’Connell, chief executive of the TaxPayers’ Alliance, told MailOnline: ‘It’s deeply concerning that taxpayers and patients are experiencing such long waiting times at many hospitals and GP centres across the country. 

‘Too often taxpayers’ money is thrown at the NHS without any thought given to the long-term solutions.’

 HOW ONLY SIX NHS HOSPITAL TRUSTS MET THE TARGET OF SEEING 95 PER CENT OF PATIENTS WITHIN FOUR HOURS 
NHS trust name Total A&E attendances Percentage in 4 hours or less (all)
The Princess Alexandra Hospital NHS Trust 9,306 64.00%
Nottingham University Hospitals NHS Trust 21,360 68.30%
Shrewsbury And Telford Hospital NHS Trust 12,842 71.40%
Stockport NHS Foundation Trust 7,679 72.00%
Salford Royal NHS Foundation Trust 8,361 72.00%
West Hertfordshire Hospitals NHS Trust 12,117 72.80%
Worcestershire Acute Hospitals NHS Trust 14,557 73.50%
Bradford Teaching Hospitals NHS Foundation Trust 10,746 73.80%
United Lincolnshire Hospitals NHS Trust 18,640 74.00%
Plymouth Hospitals NHS Trust 11,833 74.50%
Wye Valley NHS Trust 4,661 75.30%
Norfolk And Norwich University Hospitals NHS Foundation Trust 15,847 76.00%
Isle Of Wight NHS Trust 4,486 76.30%
Portsmouth Hospitals NHS Trust 17,255 76.50%
The Rotherham NHS Foundation Trust 7,905 76.70%
University Hospitals Birmingham NHS Foundation Trust 50,374 77.30%
The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust 5,311 77.30%
East Cheshire NHS Trust 3,799 77.40%
Wrightington, Wigan And Leigh NHS Foundation Trust 10,746 77.60%
North West Anglia NHS Foundation Trust 16,463 78.00%
East Lancashire Hospitals NHS Trust 14,493 78.30%
North Bristol NHS Trust 9,891 78.50%
Brighton And Sussex University Hospitals NHS Trust 16,602 78.50%
Royal United Hospitals Bath NHS Foundation Trust 9,682 78.60%
Barking, Havering And Redbridge University Hospitals NHS Trust 31,128 78.80%
Bolton NHS Foundation Trust 9,535 78.80%
Mid Essex Hospital Services NHS Trust 8,306 79.00%
Lancashire Teaching Hospitals NHS Foundation Trust 11,965 79.00%
Northampton General Hospital NHS Trust 10,601 79.10%
Medway NHS Foundation Trust 12,752 79.10%
University Hospitals Coventry And Warwickshire NHS Trust 19,539 79.10%
King’s College Hospital NHS Foundation Trust 33,806 79.40%
Warrington And Halton Hospitals NHS Foundation Trust 10,383 79.40%
Northern Lincolnshire And Goole NHS Foundation Trust 12,349 79.60%
University Hospitals Of Morecambe Bay NHS Foundation Trust 8,949 79.80%
Torbay And South Devon NHS Foundation Trust 8,168 79.80%
The Dudley Group NHS Foundation Trust 13,532 80.10%
James Paget University Hospitals NHS Foundation Trust 6,046 80.10%
George Eliot Hospital NHS Trust 6,948 80.30%
University Hospitals Of North Midlands NHS Trust 20,909 80.30%
Southend University Hospital NHS Foundation Trust 8,278 80.50%
East Kent Hospitals University NHS Foundation Trust 23,346 80.50%
Countess Of Chester Hospital NHS Foundation Trust 5,892 81.00%
Cambridge University Hospitals NHS Foundation Trust 13,257 81.10%
Mid Cheshire Hospitals NHS Foundation Trust 7,147 81.10%
Northern Devon Healthcare NHS Trust 4,257 81.40%
The Hillingdon Hospitals NHS Foundation Trust 13,259 81.40%
Hampshire Hospitals NHS Foundation Trust 9,656 81.80%
York Teaching Hospital NHS Foundation Trust 15,750 81.80%
St George’s University Hospitals NHS Foundation Trust 14,296 82.20%
Mid Yorkshire Hospitals NHS Trust 19,797 82.40%
Manchester University NHS Foundation Trust 32,661 82.40%
Barts Health NHS Trust 40,565 82.50%
Pennine Acute Hospitals NHS Trust 36,380 82.50%
University Hospitals Of Leicester NHS Trust 28,289 82.60%
University Hospitals of Derby and Burton NHS Foundation Trustÿ 28,978 82.60%
Lewisham And Greenwich NHS Trust 26,389 82.60%
East And North Hertfordshire NHS Trust 14,427 82.70%
Oxford University Hospitals NHS Foundation Trust 14,718 83.20%
University Hospital Southampton NHS Foundation Trust 15,923 83.30%
Royal Free London NHS Foundation Trust 23,009 83.70%
Wirral University Teaching Hospital NHS Foundation Trust 15,842 83.80%
Walsall Healthcare NHS Trust 11,780 84.00%
England average 1,953,782 84.20%
Poole Hospital NHS Foundation Trust 6,646 84.30%
Ashford And St Peter’s Hospitals NHS Foundation Trust 15,253 84.50%
Hull And East Yorkshire Hospitals NHS Trust 18,206 84.50%
Blackpool Teaching Hospitals NHS Foundation Trust 16,780 84.70%
St Helens And Knowsley Hospital Services NHS Trust 18,945 84.70%
Sandwell And West Birmingham Hospitals NHS Trust 19,708 84.70%
North Cumbria University Hospitals NHS Trust 9,034 84.80%
Aintree University Hospital NHS Foundation Trust 13,695 84.90%
Great Western Hospitals NHS Foundation Trust 11,946 85.00%
Dartford And Gravesham NHS Trust 10,775 85.00%
Royal Liverpool And Broadgreen University Hospitals NHS Trust 18,543 85.20%
North Middlesex University Hospital NHS Trust 17,880 85.40%
County Durham And Darlington NHS Foundation Trust 16,944 85.70%
University Hospitals Bristol NHS Foundation Trust 14,998 85.80%
Guy’s And St Thomas’ NHS Foundation Trust 17,119 86.10%
Kettering General Hospital NHS Foundation Trust 14,283 86.30%
Croydon Health Services NHS Trust 19,404 86.40%
Leeds Teaching Hospitals NHS Trust 25,565 86.50%
Frimley Health NHS Foundation Trust 26,435 86.50%
Sheffield Teaching Hospitals NHS Foundation Trust 18,264 86.60%
University College London Hospitals NHS Foundation Trust 16,419 86.80%
Birmingham Women’s And Children’s NHS Foundation Trust 6,754 86.90%
Maidstone And Tunbridge Wells NHS Trust 15,312 87.10%
Taunton And Somerset NHS Foundation Trust 9,436 87.30%
City Hospitals Sunderland NHS Foundation Trust 16,899 87.40%
Milton Keynes University Hospital NHS Foundation Trust 11,266 87.50%
East Sussex Healthcare NHS Trust 13,318 87.60%
Tameside And Glossop Integrated Care NHS Foundation Trust 11,282 87.70%
Weston Area Health NHS Trust 4,721 87.90%
West Suffolk NHS Foundation Trust 5,741 88.00%
Royal Surrey County Hospital NHS Foundation Trust 6,187 88.00%
Buckinghamshire Healthcare NHS Trust 12,472 88.10%
Southport And Ormskirk Hospital NHS Trust 11,597 88.20%
Epsom And St Helier University Hospitals NHS Trust 14,041 88.30%
The Royal Wolverhampton NHS Trust 19,693 88.40%
Bedford Hospital NHS Trust 8,377 88.40%
Airedale NHS Foundation Trust 5,364 88.60%
The Royal Bournemouth And Christchurch Hospitals NHS Foundation Trust 7,836 88.70%
Whittington Health NHS Trust 12,587 88.70%
Royal Cornwall Hospitals NHS Trust 15,206 88.90%
Salisbury NHS Foundation Trust 5,389 89.40%
London North West Healthcare NHS Trust 35,750 89.50%
Gloucestershire Hospitals NHS Foundation Trust 17,175 90.20%
Sherwood Forest Hospitals NHS Foundation Trust 12,547 90.30%
Chesterfield Royal Hospital NHS Foundation Trust 10,268 90.40%
Kingston Hospital NHS Foundation Trust 14,671 90.40%
South Warwickshire NHS Foundation Trust 6,301 90.60%
Imperial College Healthcare NHS Trust 32,042 90.80%
South Tees Hospitals NHS Foundation Trust 12,415 91.00%
Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Trust 13,387 91.00%
Basildon And Thurrock University Hospitals NHS Foundation Trust 12,962 91.00%
East Suffolk and North Essex NHS FoundationÿTrustÿ 23,470 91.30%
Dorset County Hospital NHS Foundation Trust 7,162 91.40%
Gateshead Health NHS Foundation Trust 9,394 91.80%
Homerton University Hospital NHS Foundation Trust 9,955 91.90%
Western Sussex Hospitals NHS Foundation Trust 11,900 91.90%
Calderdale And Huddersfield NHS Foundation Trust 15,499 92.20%
Royal Devon And Exeter NHS Foundation Trust 13,626 92.20%
South Tyneside NHS Foundation Trust 5,484 92.40%
Royal Berkshire NHS Foundation Trust 16,769 92.50%
Barnsley Hospital NHS Foundation Trust 7,876 92.90%
The Newcastle Upon Tyne Hospitals NHS Foundation Trust 19,035 92.90%
Surrey And Sussex Healthcare NHS Trust 16,503 93.20%
Harrogate And District NHS Foundation Trust 4,494 93.40%
Northumbria Healthcare NHS Foundation Trust 17,124 93.60%
Chelsea And Westminster Hospital NHS Foundation Trust 30,663 93.70%
Alder Hey Children’s NHS Foundation Trust 7,625 93.80%
North Tees And Hartlepool NHS Foundation Trust 13,962 95.50%
Yeovil District Hospital NHS Foundation Trust 6,165 96.30%
Sheffield Children’s NHS Foundation Trust 4,911 96.80%
Luton And Dunstable University Hospital NHS Foundation Trust 12,213 97.50%
Liverpool Women’s NHS Foundation Trust 1,067 97.70%
Moorfields Eye Hospital NHS Foundation Trust 7,279 98.80%

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