The Conservatives today accused Labor of “hiding” the true reality of horrendous A&E delays after it emerged waiting times in Wales have been largely underreported over the past decade.
This year alone, approximately 45,000 patients forced to spend at least four hours in the emergency room were quietly removed from official statistics thanks to a loophole.
It meant the Labour-led Welsh government could boast that its A&E units were “outperforming” those in England.
But an analysis by the Royal College of Emergency Medicine suggests otherwise.
Before the missing figures were discovered, official data showed that 39 per cent of all patients attending A&E in Wales had to wait four hours to be admitted, transferred or discharged in April this year.
An investigation has shown that emergency departments in Wales have for years been underestimating the number of patients forced to wait four hours or more in official published data (light blue line) and, when taken into account, throughput (blue line dark) is actually worse than England. (Red line)
Of the 2.1 million emergency department attendees in September, three in 10 (28.4 percent) had to wait more than four hours to be seen (red line). In addition, 33,107 patients waited more than 12 hours (yellow bars), which is the highest number recorded in six months and 14.7 percent more than a month earlier.
For comparison, the equivalent figure in NHS England (governed by Conservatives since 2010) stood at around 41 per cent that month.
But when missing patients are taken into account, the actual A&E throughput in Wales was almost 51 per cent.
Under NHS targets it should not exceed 5 per cent.
Conservative MP David TC Davies, acting as Welsh secretary, said the results of the RCEM investigation were “shameful and scandalous”.
He told the BBC: ‘Time and time again, the Labour-led Welsh Government has seriously let down our NHS in Wales.
“Resolving this latest scandal is a priority for the people of Wales, and I am calling on Labor to finally listen to them.”
Health Secretary Steve Barclay wrote on X, formerly known as Twitter: ‘The Labor Party has said the performance of A&E in Wales has outperformed the NHS in England this year.
But it turns out that they were hiding the figures from 45,000 patients.
“Whether for planned operations or urgent care, patients in Labour-ruled Wales are expecting more.”
However, the Welsh Government has questioned the conclusions of the RCEM analysis.
The RCEM found that NHS health boards in Wales were excluding patients who fell under a “non-compliance exemption” classification.
It covers patients who are waiting for further information or treatment in A&E, such as those who are waiting for test results before a decision is made to admit or discharge them, or who are waiting for a cast to be applied.
“Non-compliance exemptions” were introduced in 2011 to discourage hospitals from rapidly removing patients from emergency departments in Wales to meet their performance targets.
But the RCEM said the figures have been used to underestimate long emergency waits in the country.
Leading experts warned it could affect critical aspects of safety within the NHS, such as staff planning.
The university said new data showed 45,000 patients were excluded from Welsh A&E data between January and June this year alone, but the problem had persisted for more than a decade.
When this data was taken into account, it was shown that from January 2012 to June of this year, more than 670,000 patients were missing from the published data.
This is equivalent to approximately one fifth of the total number of patients treated in the emergency room in that period.
Dr Suresh Pillai, RCEM Vice President for Wales, said: “WWe have repeatedly called for “non-compliance exemptions” to be included in official statistics.
This map shows the 10 NHS trusts with the highest proportion of A&E patients forced to endure a wait of more than four hours to be admitted, transferred or discharged.
This graph shows the 10 NHS trusts with the highest proportion of A&E patients who waited more than 12 hours before being admitted, transferred or discharged.
“To omit them is to misrepresent the issue and not give a complete picture.”
He added: “If you don’t account for patients in the already overcrowded emergency department, we can’t gauge how bad things are.”
‘If you don’t get the real numbers, the perception would be “everything is fine.” When in reality it is not.
“This is crucial as we plan and prepare for what looks to be another extremely challenging winter.”
A Welsh Government spokesperson said they dispute the RCEM’s conclusions.
“Health Boards for Wales have confirmed that exceptions to breaches are included in the monthly data, in line with guidance published in 2011,” they said.
“We have not seen any evidence to support the RCEM and BBC suggestion that there has been under-reporting or that our data is not comparable with that from other parts of the UK.”
Welsh ministers have been willing to boast that their A&E was performing better than those in England.
In March this year, Welsh Health and Social Services Minister Eluned Morgan said: “This is the sixth consecutive month that the performance of Wales’ major emergency departments has improved on English performance.”
And as recently as last week, Morgan issued a press release citing official NHS data showing that Welsh A&Es had “outperformed” their English counterparts.
The argument that Welsh A&Es were achieving better results than the Conservatives in England was used to counter attacks on waiting times in Wales.
Data from earlier this year showed patients wait an average of five weeks longer for NHS treatment in Wales than in England.
Some Welsh patients are even fleeing to England for treatment due to delays.
However, England is also far behind on A&E’s performance targets.
Of the 2.1 million attendees at emergency services in September, the latest data available, three out of 10 (28.4 percent) had to wait more than four hours to be treated.
The four-hour wait goal has not been met nationally in a decade.
Additionally, 33,107 shocked patients waited more than 12 hours, more than 70 times longer than before Covid began.
But even this is an understatement, as officials were asked earlier this year to clarify the reality of the situation.
The figures record waits on trams – the time between doctors deciding a patient needs to be admitted and getting a bed.
When patients’ waits are recorded as soon as they arrive at the ER, the real situation is approximately three times worse.
These are national figures and MailOnline analysis has shown that the situation is much worse in some individual NHS trusts.
The A&E crisis in England has gotten so bad that the NHS has effectively abandoned the 95 per cent four-hour target by the end of 2022.
Instead, health chiefs have been told to focus on an “interim target” of having 76 per cent of patients seen within four hours by March next year.
But last month this website revealed that the vast majority of NHS emergency departments do not meet even this reduced threshold.