NHS failing to hit key targets on A&E and patient referrals
The NHS is under increasing pressure and failing to hit key targets relating to A&E, tests for illnesses and referring patients for treatment.
The latest performance statistics for December show a worsening across several areas, with one missed target being for people to be treated within 18 weeks.
It is the first time the 18-week target - which refers to people receiving treatment within 18 weeks of being referred by a GP or other health professional - has been missed since it was introduced in April 2012.
In December, 91.8% of people were treated within 18 weeks against the 92% target.
Meanwhile, 91% of patients were admitted, transferred or discharged from A&E within four hours of arrival - below the 95% standard.
This is the second lowest on record. The lowest was December 2014 (89.9%).
On delayed transfers of care - which occur when patients are fit to leave hospital but services such as social care are not in place to look after them - there were 154,060 days of delays in December, the second highest on record.
Ambulance targets, which were missed for most of 2015, were also missed in December.
Some 72.6% of the most serious Red 1 calls - where patients are not breathing or do not have a pulse - were responded to within eight minutes against a 75% target.
About 67.2% of Red 2 calls - still serious, such as strokes or fits - were responded to within eight minutes, far below the 75% target.
On diagnostic tests such as endoscopy, just over 2% of patients had been waiting six weeks or longer from referral, meaning the target of 1% was missed.
It has not been met since November 2013.
Clare Marx, president of the Royal College of Surgeons, said: " Doctors in the NHS are working incredibly hard and surgeons delivered a record number of operations during 2015.
"It is therefore particularly disappointing that the NHS has now missed its waiting times target. In surgery, performance has been particularly affected for operations such as hip and knee replacements.
"Delayed treatment is extremely distressing to all patients. It is welcome that the Government has promised extra money in the comprehensive spending review but we also need a long-term, sustainable plan to address the increasing numbers of patients needing surgery.
'We are also increasingly concerned by the rising number of patients being delayed from leaving hospital to go home or alternative care environments.
"This not only places the patient at greater safety risk, such as falls, or immobility which can lead to infection, but also denies much-needed hospital beds to others. The increasing delays are, it seems, partly due to the consequences of a reduction in spending on social care. We urgently need a political consensus on the funding of social care."
The data showed the NHS is managing to meet seven out of eight cancer targets.
One target is for 85% of patients to receive their first definitive treatment for cancer within 62 days of being urgently referred with suspected cancer symptoms.
In December this target was met for the first time since April 2014, with 85.1% of patients getting treated.
In other data, quarterly A&E admissions for October to December (1,442,627) were the highest since current records began.
However the total number of people attending A&E in 2015 was slightly lower than in 2014 - 22.39m compared with 22.44m.
Richard Barker, interim national director of commissioning operations and information, said the NHS was doing better than last winter. This is despite key targets still being missed.
He said: "These figures confirm the NHS is performing significantly better this winter than last winter. Patients are being seen faster in A&E, with the percentage of patients treated within four hours rising from 89.9% to 91%.
"What's more, long trolley waits are down by 84%, and emergency ambulance calls are being dealt with even more swiftly. This is a tribute to the hard work of NHS staff right across the country."
Simon Bottery, director of policy and external relations at Independent Age, the older people's charity, said: "Of the 154,000 hospital bed days lost due to delayed transfers of care, it is deeply worrying that the lack of a home care package caused 27,500 of these.
"This problem, which typically affects elderly patients, looks set to soon become the single largest cause of lost bed days. Yet we have by no means reached the end of the cuts to social care which have contributed to the rise in elderly people stuck in hospital. Councils are being told they need to make even more efficiencies in social care, yet services are in danger of being made 'efficient' to the point of collapse."
Phil McCarvill, deputy director of policy at the NHS Confederation, said: "These figures reflect increasing pressure on all parts of the health service, including acute hospitals, community and primary care services."
He added: "Hospitals don't work in isolation and cannot solve issues like cuts to social care, which nevertheless lead to increased demand for hospital beds."
Downing Street said more patients were being seen within the four-hour A&E target.
The Prime Minister's official spokeswoman said: "What the statistics show is that the overwhelming majority of patients are treated or admitted to hospital quickly.
"If you look at those being seen within the four-hour A&E target you have got 2,100 more people being seen within that target every day over the last financial year as compared to 2009/10.
"Of course, we do know that the NHS is busy in all areas. We know that it faces particular pressure during winter months like December.
"That's why the Government took measures much earlier than before to look at what contingency plans and support we had in place for that and it is why in the longer term we are investing £10 billion in the NHS."