The number of people stuck in hospital beds who are fit to be discharged is on the rise and currently higher than last winter, NHS England figures show.
NHS data analysed by the PA news agency shows increasing numbers of people in England are well enough to leave hospital but are taking up beds due to a lack of social care, support or accommodation in the community.
August data for England saw the highest average number of delayed discharges since the current data began to be collected last December.
In August, an average of 13,388 people per day were in beds but were fit to leave, while the figure was 12,899 in July and 11,590 in June.
In contrast, the figure was 10,925 people per day last December, 12,201 in January this year and 12,025 in February.
The figures also show sharp regional differences in the level of patients not being discharged.
In north-west England, an average of 3,308 patients a day were ready to be discharged in August, but only 29% actually left.
This is the highest proportion for any region.
The lowest was in London, where on average 2,476 patients a day were ready to be discharged last month, of which half eventually left.
It comes as other NHS figures show a mixed picture for the health service, with some improvements in ambulance response times, long waits and GP referrals for cancer diagnoses, but an overall record high number of people waiting for treatment.
Some 238,771 urgent cancer referrals were made by GPs in England in July, the highest number for that month in records going back to 2009, and up from 229,093 referrals in June.
Meanwhile, the proportion of patients in England seeing a specialist within two weeks in July was 77.8%, up slightly from 77.7% in June.
Elsewhere, the average response time in August for ambulances in England dealing with the most urgent incidents, defined as calls from people with life-threatening illnesses or injuries, was nine minutes and eight seconds.
This is an improvement on the nine minutes and 35 seconds in July but still below the seven-minute target.
In other improvements, ambulances in England also took an average of 42 minutes and 44 seconds last month to respond to emergency calls such as burns, epilepsy and strokes.
This is down from 59 minutes and seven seconds in July, but is still well above the target of 18 minutes.
The data also showed that the number of people waiting more than 12 hours in A&E departments from a decision to admit to actually being admitted has fallen, although the figures are still close to record levels.
Some 28,756 people waited more than 12 hours in August, down from a record 29,317 in July.
A total of 71.4% of patients in England were also seen within four hours at A&Es last month, up from 71% in July, but this is still the second-worst performance on record and well below the 95% operational standard.
The new Prime Minister inherits an NHS in critical condition— Nigel Edwards, Nuffield Trust
When it comes to long waits, some 2,885 people in England had been waiting more than two years to start routine hospital treatment at the end of July, down from 3,861 at the end of June and a peak of 23,778 in January.
The Government and NHS England set the ambition to eliminate all waits of more than two years, except when it is the patient’s choice or for complex cases requiring specialist treatment, by July this year.
NHS England defines complex cases as those where it would not be clinically safe to move a patient to another provider, or where the procedure is clinically complex and can only be done on that site or by that clinician.
Examples include patients waiting for specialist surgery that requires multiple teams or all-day theatre sessions, or patients waiting for complex spinal surgery that can only be performed in a specialist spinal surgery centre.Overall, Thursday’s data showed there were 377,689 people waiting more than 52 weeks to start hospital treatment at the end of July, up from 355,774 at the end of June.
And the overall NHS waiting list hit a new record high of 6.8m at the end of July, up from 6.7m in June.
If clear proof were needed that the pressures facing health and care are now year-round, this is it.— Patricia Marquis, RCN
Nuffield Trust chief executive Nigel Edwards said: “These figures clearly show what a monumental challenge faces the new Prime Minister and Health Secretary in delivering on the NHS.
“The total waiting list now exceeds 6.8 million, and in August over 130,000 patients were left waiting over four hours for a hospital bed. These waits are now worse than they were in previous winters. The new Prime Minister inherits an NHS in critical condition.
“This crisis has been years in the making. As our analysis published on Monday shows, the pandemic simply served to ramp up pressure on an already beleaguered health service, with staff shortages, a failure to tackle social care and inadequate investment putting the NHS on the back foot when Covid hit.
“Even without the pandemic we would have seen over five million people waiting for routine care.”
Patricia Marquis, director of the Royal College of Nursing (RCN), said: “If clear proof were needed that the pressures facing health and care are now year-round, this is it.
“Both routine and emergency care are facing incredible demands, with the waiting list for routine operations rising to yet another all-time high and the dangerous circle where delays in one part of the system impact on another as significant as ever.”
This month’s figures show that despite another significant wave of Covid infection this summer, we are making significant progress on reducing backlogs— Professor Sir Stephen Powis, NHS medical director
Richard Murray, chief executive of the King’s Fund, described ambulance service response times as “still alarming”, adding that “pressure on hospitals is symptomatic of pressure right across the health and care system”.
NHS England said the data showed that there were 1.5m patients waiting for diagnostic tests in July, fewer than the same figures for May and June and the lowest number since February, when a new NHS recovery plan was published.
It also said summer was the busiest month ever for ambulance staff dealing with the most serious callouts.
Between June and August, paramedics dealt with more than 237,000 category one incidents, up a third on pre-pandemic levels (177,190 in 2019).
NHS national medical director Professor Sir Stephen Powis said: “This month’s figures show that despite another significant wave of Covid infection this summer, we are making significant progress on reducing backlogs with waits of more than 18 months down and the lowest number of patients waiting for tests and checks since we published our elective recovery plan.
“We also saw improvements in A&E performance and ambulance response times across all measures this month, despite responding to a record numbers of the most serious ambulance callouts across summer – up a third on pre-pandemic levels – and continued challenges discharging into the community and social care.”
