The Royal rumbled – the worst Accident and Emergency department in the UK for waiting times keeps getting worse

Previously, I had written on how the Royal Victoria Hospital in Belfast had the worst waiting times in the UK in September 2014, with 64.5% of cases being dealt with within four hours, against a target of 95%. Since this analysis, data has now been published showing performance up to February 2015. For anyone who may need emergency care (i.e. everybody), the data does not make for encouraging reading. In February 2015, only 52.5% of those presenting themselves to A&E at the Royal were treated, admitted or discharged in under four hours.

This represents a new record for UK A&E units. Antrim A&E, incidentally, would have also set a new UK record if it hadn’t been for the Royal, with its score of 55% in the same month. Across the Belfast area, 533 patients had to wait for over 12 hours, representing 3.2% of the total cases of 16,645. For comparison, in the same month, 161 patients in the whole of England had to wait more than 12 hours, 0.015% of the total number of cases of 1,074,441. Patients presenting themselves to an A&E department in Northern Ireland are over 210 times more likely to face a 12 hour or longer wait than patients in England.

The usual excuse given is usually that demand for A&E services has increased. Whilst there was a modest uptick in average daily cases in February, there were 250 cases on average in the Royal in January 2015, which was the lowest number of cases for 13 months. Belfast-wide, the average case numbers of 595 in January 2015 was also lowest in 12 months. As I’ve said before, whatever is causing the crisis in A&E waiting times, increased demand is not one of the reasons.

I should point out there appears to be a methodological change in how the A&E figures are reported in the Royal, which now splits data between Ear, Nose Throat and Regional Acute Eye Services (grouped together), and all other A&E cases. If these numbers had been amalgamated for February 2015, the overall performance would have been 60%, as performance for ENT and RAES is much better (all 1,230 cases were dealt with within four hours). Of course, the argument could be that before 2015, figures for the RVH were actually worse than they were stated. In any case, it is clear that the performance of A&E units in the Belfast area, and at the RVH in particular, is both appalling and deteriorating rapidly.

With the silly season of the General Election well and truly underway, meat and potatoes issues such as A&E waiting times tends to get even less attention that it does usually, as Northern Ireland focuses on flags, parades, pacts, and all the other nonsense that we all know and love so well. Perhaps the candidates vying for a seat in the next parliament might spare a few moments to explain why, with the highest spend per capita on health in the UK, and double the number of administrative staff in the health service compared with England, we are seeing such an alarming collapse in the healthcare system.