A number of recent reports have drawn attention to hospitals’ inability to reach the A&E four hour target of seeing patients. This week, following publication of analysis by the Nuffield Trust, further concerns have been raised that even in the 'best hospitals' in England patients are waiting longer for key services. 

The Nuffield Trust has looked at various services including those covering A&E, operations, cancer and diagnostic tests. It has reported that even though most patients were still being seen within the target times at the 156 hospitals, a decline in performance has been noted. 

According to another study, the BBC's NHS Winter project, even though the four hour target has risen to 92.8%, it is still below the specified 95% target figure. This has therefore been missed every week since the beginning of the project in November 2014. 

The Nuffield Trust produced six targets concerning A&E waiting times as well as waiting times for routine operations, appointments, diagnostic testing, cancer referrals and treatment of cancer following diagnosis. A review of performance showed that the poorest performing hospitals had been 'getting worse on most measures for a while'. More recently, performance has started to decline in the top 10% of hospitals, particularly in terms of A&E and hospital operations.

Natalie Churney, an associate in Penningtons Manches' clinical negligence team, comments: “What is a real concern is that even the top hospitals are struggling to reach targets. This has a negative impact on patients and the care they rely on receiving. While the struggles in reaching the A&E four hour target have been widely acknowledged, problems in other areas such as access to planned treatment have been less well documented. They constitute a genuine cause for concern. Access to primary care, social services and the community needs to increase if pressure on the NHS is to diminish, allowing it to consistently reach its set goals.”