The number of hospitals declaring major incidents across the UK is on the rise, as figures show the worst A&E performance on waiting times in England in at least a decade.

Figures reveal that, as expected, the National Health Service in England failed to meet its A&E waiting targets for the last quarter of 2014, with just 92.5% of people being seen within the four-hour deadline, falling under the 95% goalpost.

The result is the worst seen since the introduction of the target in 2004, and marks the second time the service in England has failed to meet the four-hour benchmark, with a similar picture seen across the rest of the UK.

At least six hospitals in England have reportedly declared a major incident, which essentially means that special measures - such as calling in extra staff or cancelling routine procedures - are needed to cope with the demand. But according to claims reported by BBC News, some hospitals have even gone so far as to literally lock their doors to arriving ambulances and patients.

So why is this happening, particularly as the NHS in England alone has seen an extra £700 million this winter in emergency funding to help alleviate the pressure? Looking at all the reports, it seems the key driving factor is an unprecedented high demand on A&E departments across the country.

“In the immediate run up to Christmas the NHS treated 446,500 A&E attendees, up 38,000 on the same week last year. And there were 112,600 emergency admissions – the highest number in a single week since we started publishing performance figures in 2010,” said Sarah Pinto-Duschinsky, Director of Operations and delivery for NHS England.

Fundamental redesign needed

“This winter our local health services are responding to far-and-away the highest ever number of ambulance calls, A&E attendances and emergency admissions in the NHS’ history,” added NHS England chief executive Simon Stevens. But he also stressed “for the future it’s clear we also need a fundamental redesign of the NHS urgent care ‘front door’ – A&E, GPs, 999, 111, Out of Hours, community and social care services - as part of the broader programme of care transformation set out in the NHS Five Year Forward View.”

Nigel’s Edwards, chief executive of the Nuffield Trust, said “there have been big spikes in the numbers of people being admitted to hospital in an emergency for reasons that are not very clear,” and warned that “we may be reaching the point at which general practice, community services and social care can no longer contain the growing demand for their services”. 

This situation, he adds, is coupled with “the seasonal impact of flu and norovirus risks the system overheating in the coming months, which will put even great pressure on hospital beds and will make discharging patients even harder”. 

The Department of Health insists that the NHS "has ensured there are plans in every area to manage the extra demand," but Labour is now calling for an "emergency summit" to "devise a plan of action" as the number of hospitals declaring major incidents continues to rise.