The NHS in England has had the busiest year in its history with nearly 23 million people visiting A&E in the 12 months to March 2016, a rise of more than 500,000 from the previous year. NHS England said the ongoing dispute with junior doctors had started having an impact, with the proportion of patients waiting more than 18 weeks for operations such as knee and hip replacements hitting its highest level.

Chris Hopson, chief executive, NHS Providers, said:

“Today’s figures are predictable and reveal a maxed out health service struggling under the weight of financial strain and increasing numbers of patients requiring treatment. This deterioration will be difficult to reverse and is more the result of undeliverable demands being placed on NHS trusts and foundation trusts than their individual performance. Every trust is committed to providing the best possible care and driving improvements but we need much more honesty and realism about what level of performance trusts can deliver for patients against this backdrop.

“Despite the hard work of NHS staff across hospital, mental health, community and ambulance trusts, mounting pressure on providers has contributed to deteriorating performance across a number of key measures. 87.3% of patients were treated and assessed in A&E inside the target four hours in March – the lowest since records began in 2004. But it also came at the same time as record high attendances to A&E (7.5% more than last year), and emergency admissions up by 4% compared to March 2015. On top of this, the number of delayed transfers of care has increased by 29,538 compared to this time last year. When we run the NHS at capacity levels that no other advanced health system would even contemplate, it’s not surprising that large increases in demand lead to missed performance targets.

“Providers are finding it increasingly difficult to treat patients and get them back into their homes or into community care due to rising numbers of patients attending A&E, inadequate social care provision, and an unprecedented slowdown in funding. Patients are waiting longer for non-emergency care as beds are increasingly being filled with patients who are ready to go home but have nowhere to go. This is a problem that must be resolved by the entire health and social care system, not just NHS trusts and foundation trusts. We must, however, not forget that seeing 87% of A&E patients within four hours is a level of performance that most other health system would dream of”.