A&E: The straw that broke the camel's back

Patients waiting to see a doctor A&E waits have risen in recent years

It is often said visits to A&E units are rising rapidly. That is true, but it does not tell the whole story - as a new report shows.

Over the last four years the numbers attending A&E in England have risen by 11% to nearly 22m last year.

However, this has largely been driven by patients going to minor injury units and walk-in clinics, which are included in the national figures.

If you look at the 140 major A&E hospital trusts the numbers have been pretty steady.

So why have many hospitals been missing their waiting time target and, hence, said to be in crisis?

A new analysis by the Health and Social Care Information Centre sheds light on this.

Its report shows that there has been a small, but significant increase in the number of over-65s attending the major A&E units.

BBC Winter Facebook page

Tell us your A&E experience by:

  • using the contact form below, or

As a proportion of overall attendances they now account for 21% of the total - up from 19% four years ago.

This is likely to be largely driven by the ageing population, although some have suggested cuts in community health and social care budgets have made it harder to keep elderly people well,

In numbers terms it amounts to a surprisingly small amount of patients, about 150,000.

However, these people are more likely to need tests and monitoring and, therefore, take longer to see in A&E.

The change - described as a "subtle shift" by information centre chair Kingsley Manning - has meant standards have dropped.

Performance is measured by the proportion of patients who wait longer than four hours to be seen.

In 2008-9, just under 3% did, but by last year this had risen to just over 6% for major A&E units.

The NHS is meant to keep it below 5%.

The growth in older patients is, in effect, the straw that has broken the camel's back.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

Savile: Why the risks are real in today's NHS

Jimmy Savile's abuse on NHS premises spanned 44 sites. Most of the cases were decades ago, but how safe is the health service now?

Read full article

More on This Story

More from Nick


This entry is now closed for comments

Jump to comments pagination
  • rate this

    Comment number 261.

    The NHS was broken at conception. All the problems we see with the NHS is the system running its logical course, even the people themselves complaining about the elderly being a burden is the logical end result of socialized health care.

  • rate this

    Comment number 260.

    There are two distinct problems.
    The fact we live longer is only of marginal effect, because we also work longer, if the jobs are available.
    The demographic of baby bulges is more pronounced. However, importing young immigrants to reduce the average age of the population is a Ponzi scheme that makes the first problem worse as well.
    We need investment and productivity.
    Nationalise the banks!

  • rate this

    Comment number 259.

    232.scottish astronomer
    3rd December 2013 - 21:58
    'You want GPs to work until 10pm'

    'Due to the vast amounts of paperwork... GPs are still working 12 hours or more per day, five days a week.'

    Would it be possible for some GPs to do their paperwork in the morning or afternoon and run an evening surgery instead? No more hours but a chance for working people to get to see them.

  • rate this

    Comment number 258.

    The problem with many hospitals, including the one I work at is that the government will give us a budget for the year but we can not spend it all as the government want us to return some of that budget as 'savings' This year alone, my hospital has to save £8m and save £50m over the next 10 years.

  • rate this

    Comment number 257.

    The NHS needs to start using its budget, available staff and modern technology much more wisely and effectively. It may mean a big turnaround in the way it provides patient care but if the police and the teachers can do it then the NHS can and a bit quicker. If the staff are the problem then maybe they either need to commit to team playing or move on.


Comments 5 of 261



Copyright © 2015 BBC. The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.