Thousands waiting hours for hospital beds, slow ambulance response times and lengthening waiting lists, even before the heatwave increased health risks and ambulances reported being under extreme pressure.
This week all ten ambulance services across England put themselves on the highest alert level, saying they're struggling to effectively meet demand. At the same time, the UK Health Security Agency declared a Level 3 heat-health alert for much of the country warning of the increased risk to health, with a likely increase in demand for NHS services.
The latest NHS figures show, in June, 22,034 people across England waited more than 12 hours in A&E to be admitted to a ward bed, after a decision to admit them was taken. That was up from 19,053 in May, and the third highest number since records began in August 2010.
More than a quarter (27.9%) of patients arriving in A&E are waiting more than four hours before being admitted, discharged or transferred - the target is just 5% should wait this long.
Delays admitting people to wards from A&E can be impacted by issues with discharging patients who are well enough to go home from beds. In June, an average of 11,989 people each day were in hospital when they could have left, although that was down from 12,228 in May and 12,589 in April.
An interim report by the Healthcare Safety Investigation Branch found that demand on services, the availability of beds and patient flow through acute hospitals (including the discharge of patients to social and community care) affected the ability of ambulances to hand over patients to emergency care. It warned patients who wait in ambulances at an emergency department are at potential risk of coming to harm due to deterioration or not being able to access timely and appropriate treatment.
The Association of Ambulance Chief Executives told the investigation that there is a strong correlation between ambulance handover delays and increasing ambulance response times. In June, the average response time for a Category 1 call, the highest priority life-threatening calls, was nine minute and six seconds, above the target of seven minutes.
Ambulances should get to Category 2 emergency calls, ones that aren’t immediately life-threatening but where rapid assessment of symptoms that could be a stroke or heart attack are needed, in 18 minutes on average. On average, these calls are taking 51 minutes and 38 seconds.
For urgent calls, 90% of ambulances should arrive within two hours. In June, 90% of urgent calls were arriving within seven hours and 21 minutes, according to figures from NHS England.
In other parts of hospitals, it's a more mixed picture. NHS Trusts continue to make good progress on the target to ensure no one waits more than two years for routine treatment by the end of July.
As of the week ending July 3, there were 3,548 still waiting more than two years for treatment, compared to 8,028 at the end of May. However, the number of people waiting over a year from treatment had risen from 323,093 in April to 331,623 in May, and the overall number of people on the waiting list rose to a new record high of 6.61 million.
Diagnostic tests are a key part of getting people the right treatment, and the NHS carried out 2.065 million tests in May. However a quarter (26.0%) of people who need tests such as MRIs and CT scans have been waiting more than the target time of six weeks.
People with suspected cancer are also being seen more quickly. Of those seen by a consultant in May after an urgent referral from their GP, 83.2% were seen within the target time of two weeks, up from 79.1% in April.
However, waits for cancer treatment worsened, with 61.5% of those starting treatment within May doing so within two months of an urgent referral. That was the worst performance since records began in October 2009.
Professor Sir Stephen Powis, national medical director for NHS England, said, in the same week NHS staff received the George Cross for their exceptional efforts throughout the pandemic, the figures show hardworking teams across the country are making good progress in addressing the Covid backlogs.
He said: “There is no doubt the NHS still faces significant pressures, from rising Covid admissions, thousands of staff absences due to the virus, the heatwave, and record demand for ambulances and emergency care. The latest figures also continue to show just how important community and social care are in helping to free up vital capacity and NHS bed space – supporting those in hospital to leave when they are fit to do so, which is also better for patient recovery.
“While the current heatwave is not shown in today’s figures, it also affects NHS capacity – but it remains important that anyone needing emergency care dials 999, and the public use 111 online and local pharmacies for other health issues and advice.”
