Twelve-hour A&E wait times quadruple in a single year, the worst on record

Twelve-hour trolley waits in A&E have quadrupled in a single year, NHS England figures show.

The number of patients waiting on trolleys in hospital corridors reached 2,846 in January 2020, compared with 627 in the previous year.

This is the highest level recorded since data collection began in 2010 – even though this winter flu season has been mild.

Doctors’ organisations called the figures ‘unacceptable’ but unsurprising. They warned patients were at risk and doctors were run to the ground. 

Cancer treatment times were also the worst on record, with only 78 per cent of patients starting treatment within two months of being urgently referred for suspected cancer.  

Targets for cancer patients to start treatment have not been met for six years, and show no sign of improving.

Twelve-hour trolley waits in A&E have quadrupled in a single year, NHS England figures show. Of those waiting more than four hours, 2,846 were delayed over twelve hours. It’s four times the figure in January 2019 – 627 – and a staggering 18 times the figure in 2016 – of 158

The figures released today lay bare how much pressure the NHS is working under.

The number of patients seen and discharged within four hours was 81 per cent in January 2020, a three per cent decrease on the equivalent figure for January 2019. 

More than 100,500 patients had to wait more than four hours compared with 83,554 in the same month in 2019.

This is the highest level of four-hour delays from decision to admit to admission since the collection began.

The 95 per cent standard for four hours has not been met since July 2015, and only one of 118 NHS trusts achieved it in January 2020.

Of those waiting more than four hours, 2,846 were delayed over twelve hours, the highest ever level.

It’s four times the figure in January 2019 – 627 – and a staggering 18 times the figure in 2016 – of 158.

Dr Nick Scriven, past president of the Society for Acute Medicine, said the figures came as no surprise.

He said: ‘The fact the NHS is teetering on the brink is now such common knowledge that it is no longer a shock to see continuous failure to meet performance targets and, even today, with the figures showing the worst ever performance against emergency targets since data collection began, it will barely raise an eyebrow.’

‘This performance data, however, is not any reflection on the mammoth efforts of frontline staff to deliver in almost impossible circumstances – something reinforced by those who battled last weekend’s wild weather for their patients.’ 

In response to NHS England’s January performance statistics, the British Medical Association said the Government is ‘failing to get a grip on winter pressures’.


The NHS figures revealed today show that ambulances attended 750,238 incidents in January, making it the busiest January on record.

An NHS spokeswoman said January had seen improved A&E performance and faster ambulance response times compared with December, according to PA.

She said: ‘This was aided by the sustained hard work of NHS staff, and the ability to open and staff more hospital beds than last year.

‘This means that the NHS is well ‘prepared to deal with the potential impact of coronavirus, although it remains important that anyone with health concerns should contact NHS 111.’

It follows statistics which revealed ambulance delays were the worst they have been in at least two years in the first week of 2020.

Almost one in five ambulance patients (18 per cent, equal to 18,000 people) wait more than half an hour to be handed over to hospital staff.

Council chair Dr Chaand Nagpaul said: ‘This latest set of performance figures confirm what doctors have been telling us and indeed the reality experienced by patients daily; that the strain on our health service is relentless, deepening and showing no sign of recovery.

‘Stories of patient deaths on corridors, rammed emergency departments and cancellations of patient’s procedures as a daily occurrence are becoming the new norm as doctors across the country say they are exhausted and run into the ground.

‘This is an unacceptable situation for a civilised health service; it is failing patients and is not sustainable.’

Tim Gardner, senior policy fellow at the Health Foundation, said: ‘Today’s figures show NHS performance on the main waiting time targets is close to record lows.

‘Despite the lack of a cold snap and flu being less severe than feared so far, this was the worst January for people waiting longer than four hours in A&E since records began.’

Unless widespread NHS staff shortages are tackled, patient care will continue to suffer, Mr Gardner said.

Susan Masters, director of Nursing Policy and Practice at the Royal College of Nursing, said: ‘It is shocking to learn that last month, over 100,000 emergency patients in England had to wait more than four hours on trolleys or chairs for a hospital bed, the highest number ever.

‘It is extremely difficult for nurses to provide safe and effective care in these circumstances, as well as extremely distressing for patients and their families.

‘But hospitals cannot open more beds without more nurses to staff them – and there are currently over 43,000 vacant nursing posts in the NHS in England alone.’

December data for the past nine years reveals the number of people waiting more than four hours in A&E has soared from a low of 66,661 in 2011 to a record high of 396,762 in 2019

December data for the past nine years reveals the number of people waiting more than four hours in A&E has soared from a low of 66,661 in 2011 to a record high of 396,762 in 2019

Cancer targets have not been met in six years 

Data published today also highlighted the worsening treatment wait times cancer patients in England must face after a diagnosis.

The year 2019 was the worst calendar year on record for all eight Cancer Waiting Times targets, as figures show:

  • A 30 per cent rise in the number of people waiting longer than two weeks for a first appointment with a consultant after an urgent referral from a GP. The figure in 2019 was 214,000, around 49,000 more than in 2018.
  • A 16 per cent increase in patients waiting longer than 62 days to start treatment after an urgent GP referral in 2019 than in 2018 – 4,900 more. 
  • Over half of NHS hospital trusts in England (64 per cent) missed the 62-day target in December 2019. 
  • Only 78 per cent of patients in England started treatment within two months of being urgently referred by their GP with suspected cancer, against the target of 85 per cent. 

Until January 2014, the NHS was able to consistently keep pace with demand and the 62-day target was almost always met.

Lynda Thomas, CEO of Macmillan Cancer Support, said: ‘These waiting times are unacceptable.

‘It’s disappointing that, despite the best efforts of frontline staff in the NHS, latest figures expose 2019 as the worst ever year on record, with December marking six years since the 62-day wait to start treatment was first breached.


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.

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.

‘As the NHS staffing crisis worsens so do delays, and the impact of this is being felt acutely by people living with cancer.

‘We must remember that behind every missed figure is a real person who has a life and a family, a person who faces delays to receiving results, starting treatment or seeing a consultant.’

And Ellen Lang, a nurse on Macmillan’s Support Line, said: ‘We hear from people all the time who tell us how uncertainty about tests or treatment can be physically and emotionally draining, at what is often already a distressing time.’

Separate figures also released today reveal the volume of planned operations that were cancelled in the winter months.

In the months October to December, 16 per cent more surgeries were cancelled compared to the same period in 2018.

There were 23,503 cancellations in the run-up to Christmas 2019, up from 3,337 on the same period the previous year.

One in ten patients were not treated within 28 days of their cancelled operation.

Professor Derek Alderson, president of the Royal College of Surgeons of England said: ‘This has to change.

‘Christmas was cancelled for a record number of patients last year. A cocktail of pressures is hitting our hospitals: winter illnesses, staff shortages and a lack of beds.

‘Cancelling on the day heaps additional distress on what is already a stressful situation for patients and their families. Their condition may deteriorate further while they wait for a new operation date.’

Professor Alderson pointed to a RCS survey of 421 surgeons working in the NHS in November 2019, asking why operations were being cancelled on the day.

It found that 60 per cent of surgeons had to cancel operations at the last minute, with the top reason being a lack of beds.

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