A quarter of patients waited more than four hours in Birmingham A&Es last month - with waiting times the worst on record.

At University Hospitals Birmingham, just 73.5% of patients waited less than four hours from arrival to admission, transfer or discharge in December.

This was the trust’s worst performance since A&E waiting times began being measured on a monthly basis in June 2015.

Patients visiting the trust’s major A&Es were even more likely to face long waits, with just 71% waiting less than four hours - another record low.

At Sandwell and West Birmingham NHS trust, 75% of patients waited less than four hours in all of the trust’s A&Es, while for those using its major A&Es, 67.4% waited less than four hours.

Both of these were the trust worst performances on record.

At Birmingham Women and Children’s Hospital, 86.7% of patients spent less than four hours in A&E in December.

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According to the latest figures covering last week, A&Es run by University Hospitals Birmingham agreed to temporarily divert patients to other A&E departments to relieve pressure twice between December 31 and January 6.

Figures out this morning also show that 95.4% of general beds at the trust were occupied last week, as were 95% at Sandwell and West Birmingham, and 85.1% at Birmingham Women and Children’s Hospital.

Health experts advise that occupancy levels should ideally be under 85%. Anything over this level is regarded as riskier for patients as this leads to bed shortages, periodic bed crises, and a rise in healthcare-acquired infections such as MRSA.

A study published in the Emergency Medicine Journal found that reducing bed occupancy to 90% or less led to a drop in death rates and an improvement in waiting time performance in A&E.

At Sandwell and West Birmingham, 92.4% of critical care beds were occupied in the week ending January 6, and so were 88% at University Hospitals Birmingham and 85.1% at Birmingham Women and Children’s Hospital.

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The Royal College of Anaesthetists’ says persistent critical care bed occupancy of more than 70% suggests that a unit is too small, and occupancy of 80% or more is likely to result in non-clinical transfers that carry associated risks.

Demand on NHS resources in Birmingham means dozens of ambulances a day are having to wait before off-loading patients into A&E.

Trusts across the area saw 634 ambulances wait more than 30 minutes to handover patients in the week ending January 6, with 89 waiting more than an hour, according to the NHS England figures.

The target is for handovers to take under 15 minutes.

At University Hospitals Birmingham, a fifth of ambulances arriving in the last week (22%) had to wait more than 30 minutes to handover, a total of 591 ambulances.

 

Across England, in December 2018, 86.4% of patients waited longer than four hours from arrival to admission, discharge or transfer, according to figures released by NHS England this morning.

This was down from 87.6% in November, but was higher than the 85% recorded in December 2017.

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Patients were more likely to face long waits in major A&Es - 79.3% waited less than four hours in December, compared to 76.9% in December 2017.

There were 280 patients in December who had to wait more than 12 hours from a decision to admit to admission, so called trolley waits. However, this was down from 517 a year before.

President of the Royal College of Emergency Medicine, Dr Taj Hassan said: “It is commendable that four-hour performance is better than in December 2017 and a testament to both our staff and the measures put in place to mitigate the impact of winter.

“While it isn’t a huge improvement, and 63% of our Emergency Departments remain in the Red Zone, it is certainly welcome for patients; particularly in the context of the highest ever attendances and admissions for a December.

“However, it should also be remembered that the last few months have been particularly benign in terms of the weather and instances of flu have so far been lower than in previous years.”

The latest figures covering hospital performance between December 31 and January 6 suggest that hospitals are continuing to cope better that last winter.

In A&E, patients had to be temporarily diverted from busy departments 17 times in the week ending January 6, compared to 32 times in the week ending January 7, 2018.

The latest NHS England figures charting the situation in hospitals this winter shows that in the week ending January 6, 12,285 ambulances had to wait more than 30 minutes outside A&Es.

This was the equivalent of one in eight (12%) of ambulances arriving.

A total of 2,986 ambulances had to wait more than an hour to handover.

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In the week to January 7, 2018, 16,690 ambulances took more than an hour to handover patients at A&Es, with 5,082 taking more than an hour.

This was the equivalent of one in six ambulance arrivals (17%).

The occupation rate for general and acute beds was 93.2% in the first week of 2019, which compares to 95% in the same week in 2018.

Critical care beds were also less busy, with 78.5% of beds occupied, down from 82.2% in 2018.

There were 597 beds closed because of norovirus-type symptoms as of January 6, compared to 819 as of January 7, 2018.

The number of beds occupied by patients who had been there for more than a week as of the same date was down 7% compared to a year before, and stays of over three weeks were down 10%.