Last updated:

BMA analysis shows year-round crisis with services struggling in summer as badly as recent winters

A new BMA analysis has shown emergency care services in England are suffering an “year-round crisis" with key indicators demonstrating the summer of 2018 delivered worse levels of care to patients than five out of eight recent winters.

The analysis is based on an examination of data released each month by NHS England that shows the level of pressure on emergency care services1.  According to these figures, 200,000 more patients were left stranded for more than four hours on a trolley waiting for care after being admitted to hospital in the most recent winter period compared to the same timeframe in 20112.

In light of these findings, doctors’ leaders have warned the government must ensure extra funding reaches frontline services this winter.

Key figures from the BMA study include:

The current crisis

  • In a snapshot of three summer months of 2018 (July to September), 125,215 patients were left waiting on a trolley for more than four hours after the decision to admit, a figure that was greater than every winter (defined as January to March) between 2011 and 2015.
  • The figures were not far behind the last three winters, which registered increasing numbers of patients stranded on trolleys at 155,277 in 2016, 177,012 in 2017 and a record 226,176 in 2018.
  • Compliance with the waiting targets for patients to be seen in A&E, also set at four hours, were lower in the summer of 2018 than the winters of 2011 to 2015, with new lows recorded in the last three winters.

Comparing winter 2011 and winter 2018 (January to March)

  • Compliance with the four-hour waiting time to be seen, admitted or discharged from A&E reduced from 96.6 per cent to 85.0 per cent.
  • Total trolley waits of longer than four hours increased from just 29,636 to 226,176, a seven-fold increase.
  • Total emergency admissions increased from 1,290,056 to 1,529,087 an rise of 19 per cent.

Comparing summer 2011 and summer 2018 (July to September)

  • Average A&E four hour wait compliance reduced from 97.3 per cent to 89.3 per cent.
  • Total trolley waits of longer than four hours increased from 18,095 to 125,215, a six-fold increase.
  • Total emergency admissions increased from 1,247,113 to 1,558,691, an rise of 25 per cent.

Dr Chaand Nagpaul, BMA Council Chair, said:

“These figures lay bare the long-term underfunding of emergency care services in England that have experienced years of declining budgets and staff shortages at a time when patient demand has rocketed. It is shocking that the number of patients waiting more than four hours for treatment on trollies has increased seven-fold during the winter months since 2011, with almost 200,000 more patients left in this appalling situation. Compliance with the four-hour waiting time target has dropped 11 per cent since 2011 and even during the supposedly quieter summer period there have been similar declines.

“Most worryingly, the pressure on the NHS has developed into an all year crisis. The BMA correctly predicted that the summer of 2018 would be as bad as many recent winters.

Dr Simon Walsh, an emergency care doctor and member of the BMA’s consultants committee said:

“Behind these figures lie real stories of misery. Tens of thousands of patients are being left in crowded, cramped corridors, waiting for treatment while others are having to endure longer waits to even see a doctor or nurse. We cannot and should not allow this appalling state of affairs to continue.

“The recent budget showed signs that the government is beginning to understand that extra investment is needed. But this analysis shows the NHS needs this funding urgently.  The BMA remains unconvinced that what has been pledged will meet the sheer scale of the problems underlined by our analysis. It is vital that the government ensures that frontline healthcare staff are given the resources they need to deliver the standard of care that patients deserve.”


Notes to Editors

  1. The BMA examined three key indicators based on data from NHS England which can be found here. These indicators are:
  • Emergency admissions
  • Trolley waits of more than four hours (i.e. the time spent between being the decision to admit, and admission)
  • The percentage of A&E attendances which were completed within four hours

Information about the data analysis from the BMA can be found here.

  1. Within this analysis, the BMA also sort to compare the pressure services during winter and summer period. There is no agreed definition of when the winter and summer months begin and end. The BMA opted to look at a three-month period including the averaged “hottest” (i.e July/August) and “coldest” (i.e January) months. The definition of winter and summer is therefore:

Winter: January to March

Summer: July to September

The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

For further information please contact:

British Medical Association, BMA House, Tavistock Square, London, WC1H 9JP
Telephone: 020 7383 6448 
Email: [email protected]
Media centre | Twitter | Youtube - BMA TV | Flickr