NHS performance dashboard
There are thousands of possible statistics available to measure the performance of the NHS. Here, we have selected a small group that reflect key issues of concern to the public and patients as well as providing some indicative measures of the impact of tackling the productivity and reform challenges confronting the NHS.
1. Health care-acquired infections
C difficile infections remain below 400 cases a month, showing continued achievement in the face of continued operational and financial pressures. Similarly, the number of MRSA infections remains low – a total of 22 in June across England (Figure 21).
The number of reported MSSA infections in June 2016 are the highest (297) since January 2011, and there are growing numbers of E coli infections (albeit with large seasonal variations). We will continue to monitor these to see if they reflect increases in population or are a sign of growing health care-acquired infections.
Data source: Clostridium difficile infection: monthly data by NHS acute trust http://www.gov.uk
Monthly counts of methicillin resistant Staphylococcus aureus (MRSA) bacteraemia by post infection review (PIR) assignment http://www.gov.uk
Monthly counts of trust apportioned methicillin susceptible Staphylococcus aureus (MSSA) bacteraemia by NHS acute trust http://www.gov.uk
Monthly counts of Escherichia coli (E coli) bacteraemia by NHS acute trust www.gov.uk
Using the recalculated workforce figures following the introduction of the new definitions, in May 2016 the total number of full-time equivalent (FTE) staff working in hospital and community health services (excluding, for example, general practitioners) was more than 1.027 million (Figure 22).
Compared to May 2015, there has been an increase in all staff of 24,722 FTE posts (2.5 per cent). This has been across all staff groups: consultant numbers have increased by 3.5 per cent; total managers by 4 per cent; scientific, therapeutic and technical staff by 2.5 per cent; and nurses, midwives and health visitors by 1.1 per cent.
Data source: Monthly NHS Hospital and Community Health Service (HCHS) Workforce Statistics in England – May 2016, Provisional statistics http://www.digital.nhs.uk
3. Waiting times
The proportion of patients still waiting to be seen 18 weeks after referral increased to 8.5 per cent in June 2016 (Figure 23). This breaches the target (8 per cent) for the fourth month in a row. In total, there were more than 307,000 patients who were still waiting to begin their treatment 18 weeks after referral at the end of June 2016, and more than 940 of these patients have been waiting for more than a year.
For the targets that were dropped last year, latest figures show that the proportion of admitted patients treated after having waited more than 18 weeks increased to more than 20 per cent in April and June 2016. The proportion of non-admitted patients who waited more than 18 weeks for treatment has also increased to almost 8 per cent in June 2016.
The total elective waiting list continues to grow. In June 2016 the total waiting list increased to 3.63 million, more than 336,000 additional patients compared to January 2016.
Furthermore, this total does not include several trusts that have not been reporting their waiting lists. Including these, NHS England estimates that the true waiting list in June 2016 was more than 3.8 million patients (Figure 24). This puts the waiting list back to the highest level since December 2007.
Data source: Referral-to-treatment waiting times statistics www.england.nhs.uk
The proportion of patients waiting more than six weeks for a diagnostic test has now missed its target (1 per cent) for the past 31 months in a row.
The overall waiting times target for cancer treatment is that no more than 15 per cent of patients should wait more than 62 days from an urgent referral from their GP to receiving treatment for their cancer. This target was met from quarter 4 2008/9 until quarter 4 2013/14, when it was missed. In the latest quarter (April to June 2016) performance improved slightly to 17.6 per cent. This standard has not been met for the past two and a half years (Figure 25).
Data source: Provider-based cancer waiting times www.england.nhs.uk
4. Urgent care
Since June 2012 ambulance trusts have been given eight minutes to respond to the most urgent cases, and nationally no more than 25 per cent of these calls should be responded to outside of this time.
This standard was met until 2013/14 but for all subsequent years has been missed. In the most recent data for May and June 2016, performance worsened to 29.5 and 30.8 per cent of calls being responded to after eight minutes respectively. This is the worst-ever performance seen in May or June since this target was introduced (Figure 26).
Data source: Ambulance quality indicators www.england.nhs.uk
Accident and emergency
In quarter 1 2016/17, the proportion of patients waiting more than four hours from arrival to discharge, admission or transfer in all A&E departments was 9.7 per cent. This is the highest level in the first quarter of the year since 2003/4 (Figure 27).
Over the quarter, more than 572,000 patients spent longer than four hours in A&E departments. With the exception of quarter 4 2015/16, this is the highest number of people waiting more than four hours since 2003/4.
Pressures to admit more patients continued to impact performance against the four-hour target in the first quarter of the year (Figures 28 and 29). Compared to the same quarter last year A&E attendances were up 2.8 per cent and emergency hospital admissions from A&E increased by 4.2 per cent.
These small percentages represent large numbers. The increase equates to more than 161,000 more attendances and almost 42,000 more admissions to hospital in the first quarter of 2016/17 compared to 2015/16.
To put it another way, for each month so far in 2016/17 this is the equivalent of an additional 54,000 attendances at A&E departments and 14,200 admissions from A&E compared to the previous year.
- There has been an increase in the number of patients waiting more than four hours from decision to admit from A&E to admission to a hospital bed on a ward (‘trolley waits’): more than 112,500 patients in quarter 1 2016/17, an increase of 41,126 (58 per cent) on the same quarter 2015/16 (Figure 30).
5. Delayed transfers of care
At the end of June 2016 more than 6,100 patients were delayed in hospital, the highest number since 2007 (when these figures were first collected in this way) and an increase of 22 per cent on the same month last year (Figure 31).
The number of total days delayed increased to more than 171,000 in both May and June 2016, the highest number of delayed days in any single month in this data (Figure 32). Figures for June 2016 are 23 per cent higher than the same month last year.
Data source: Acute and non-acute delayed transfers of care, patient snapshot, 2016/17 www.england.nhs.uk