A&E waiting times at nine-year high: More than 300,000 patients do not see doctor for at least four hours

Waits before being admitted from A&E into hospital – so-called trolley waits – of more than four hours, have also risen to almost 7 per cent, the highest level since 2004

GPs have rejected Mr Hunt's suggestions that their failure to properly manage out-of-hours care has been responsible for increased demand at A&E (Susannah Ireland)

More than 300,000 patients had to wait for over four hours in A&E between January and March as Britain’s emergency health services continued to show the strain from ever-increasing demand.

Two new reports into A&E performance at the start of this year reveal that Trusts missed Government targets for the first time since June 2011 and that the knock-on effects of A&E overcrowding are being felt across the health service, with scheduled appointments being cancelled and cancer targets being missed.

Analysis by the King’s Fund found that 5.9 per cent of patients – 313,000 – waited for more than four hours in A&E, an increase of more than a third on the previous three months and up 40 per cent on the same period last year. According to Government targets no more than five per cent of patients should wait more than four hours.

Waits before being admitted from A&E into hospital – so-called trolley waits – of more than four hours, have also risen to almost 7 per cent, the highest level since 2004.

In a separate report, health care regulator Monitor said that more than half of all NHS Foundation Trusts with A&E wards had breached targets, and the effects were beginning to be felt further down the system. In some cases Trusts have had to cancel elective procedures to deal with increased A&E pressures. Some patients had to wait longer before starting cancer treatment – partly due to reductions in capacity associated with emergency pressures, the report said.

Recent figures showed that 220 planned operations were cancelled with less than 24 hours’ notice in the first three months of this year.

The figures represent the latest evidence that A&E wards are struggling to cope with increased demand, and follow reports that the number of ambulances diverted away from overcrowded A&E wards has increased by 24 per cent in a year and that the number of patients waiting more than half an hour in the back of an ambulance increased by 100,000 between 2010 and 2012.

The Kings Fund’s chief economist, John Appleby, said that pressures on emergency care were “a barometer for the NHS”.

“The worryingly high number of patients waiting longer than four hours in the last quarter of 2012/13 is a clear warning sign that the health system is under severe strain,” he said.

A spokesman for the Health Secretary, Jeremy Hunt, blamed the previous Government for allowing GPs to opt out of out-of-hours care, leading more people to resort to A&E services.

“A&E services are facing increased pressure because of Labour’s disastrous GP contract and problems with integration that they failed to address,” the spokesman said.

GPs have rejected Mr Hunt’s suggestions that their failure to properly manage out-of-hours care has been responsible for increased demand at A&E. Failures with the new 111 non-emergency phone number, which has mistakenly sent people to A&E, have also been blamed.

A Department of Health spokesman said that A&E departments had since improved and had now hit their targets for five weeks in a row.

“Clearly the NHS had a difficult winter and A&E departments were under pressure,” the spokesman said. “This is partly due to the fact that there are over one million more people visiting A&E compared to three years ago.”