A&E Winter Performance

MQT on 2016-12-14
Session date: 
December 14, 2016
Question By: 
Onkar Sahota
Labour Group
Asked Of: 
The Mayor


Is the Mayor concerned that of London's 18 Hospital Trusts that run A&Es, 15 failed to hit the government's target to see 95% of patients within four hours for the entire year, and what concerns does he have over equitable access to healthcare services, and the resilience of London's emergency services, for the forthcoming winter?


Answer for A&E Winter Performance

Answer for A&E Winter Performance

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  Yes, I am concerned.  Winter is the busiest time for the NHS with increases in admissions placing the health system under more pressure.  Accident and emergency (A&E) departments are the front line of the NHS and I want to pay tribute to those doctors and nurses working in the hospitals for the tremendous contribution they make to London.  I would also like to thank the NHS staff who will be working over the Christmas period whilst many of us are having time off.  Their work is especially important over this period as winter sets in. 


While I accept there is variation between hospitals in respect of their performance, poor performance impacts on the ability of all Londoners to access health services as it is an integrated system.  I met Anne Rainsberry, NHS England Regional Director for London, last month and she briefed me on the NHS performance challenges facing London.  I also met Anne Rainsberry at my London Health Board meeting last week.  I am advised that London health systems are implementing an A&E improvement plan that aims to deliver sustainable improvement of the A&E standards.  As you know, my powers with regard to the NHS are limited but I will continue to meet and challenge NHS leaders on this area. 


With respect to resilience, you will be aware that Lord Harris recently completed his review into London’s terror preparedness and has recommended increased funding for the London Ambulance Service.


Dr Onkar Sahota AM:  Thank you, Mr Mayor for that answer.  You must be concerned that the 15 out of the 18 trusts in London have not hit their targets, particularly in North West London, where we have had two A&E closures at Ealing Hospital and at Central Middlesex.  It has put huge pressure on the other hospitals in the area.


Do you think that the NHS should put a stop to the closure of the A&Es remaining and that we should not close the A&Es at Charing Cross and Ealing Hospital?  Would you join me in putting pressure on the A&Es to do that?


Sadiq Khan (Mayor of London):  Yes.  I have supported the campaigns in the past.  The A&E downgrades in Hampstead and Central Middlesex have caused huge problems, particularly with Northwick Park Hospital.  There should be clinical input.  Public consultation is crucial.  I worry and it should be no surprise that this is happening. 


I am looking forward to us seeing the benefits of the additional weekly contribution of £350 million we were promised if Britain chose to leave the European Union (EU).  There is no evidence that that money has come so far.  I am looking forward to it coming sooner rather than later.


Dr Onkar Sahota AM:  Yes.  Also, I join you in congratulating all the NHS staff who are working hard and will continue to work hard.  Of course, some people would say that there is inappropriate attendance at A&E departments and they should be going to their GP services rather than coming to the A&E departments.  The only problem is that the GP services are also crumbling and GPs are handing back the keys and saying, “Can you take this shop back from us?”  There is a recruitment problem in London, we have a problem recruiting nurses and there is nowhere for this patient to go to.  The A&E department is, as you say, the front line and the whole system is under pressure.  The NHS needs to revisit this, particularly as you say that it is really being underfunded.  That is a real issue. 


Sadiq Khan (Mayor of London):  I do not just pay tribute to you but I pay tribute to all NHS staff.  Whenever I meet them, I am impressed by them and inspired and humbled.  I have never met a more demoralised NHS staff than I have at the moment.  The whole ecosystem is fragile.  From the long waiting times to see your GP to out-of-hours service and social care, it is a real source of concern to councils as to how they are going to fund it.  There is a horrible phrase, which I hate, “bed-blocking”.  You will know the links there are to being places for inpatients in hospitals and social care and the lack of confidence in doing that.  You will also be aware of the queues of ambulances not able to get their passengers from the ambulance to the A&E because of the problems in A&Es.


I thought the days where we would see patients on trolleys in corridors had gone  because of our record investment in the NHS between 1997 and 2010.  People say we did not fix the roof when the sun was shining.  We did not just fix the roof; we built new GP practices; we built new hospitals and we built new wings.  All roads lead back to a lack of investment in our NHS.  We started to spend the same amount per patients as our European neighbours; we are now spending far less when you bear in mind inflation in the NHS.  Doctors are demoralised, nurses are demoralised, ambulance workers are demoralised and carers are demoralised.  This winter I worry.  Of course I pay tribute to the NHS staff, but I worry about your patients and Londoners.


Dr Onkar Sahota AM:  Thank you, Mr Mayor.  It is really refreshing to hear that you are taking a keener leadership role in this matter.


Tony Arbour AM (Chairman):  Thank you very much.