Image: Liverpool Echo

By stewartb

The latest A&E waiting times data for NHS England, for the month of October, have just been published (10 November). It’s become a regular past-time to use these occasions to examine BBC editorial standards – for accuracy, completeness, impartiality, and proneness to bias by omission – in the different nations of what BBC news journalists typically refer to as ‘the nation’ of the UK. Candidly, as regular readers of TuS will know, it proves to be ‘an education’!

This is the official source: ‘A&E Attendances and Emergency Admissions October 2022 Statistical Commentary’ (https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2022/11/Statistical-commentary-October-2022-cftre1.pdf

Worst on record!

Here are the key performance statistics for NHS England (with my emphasis):

’69.3% of patients were seen within 4 hours in all A&E departments this month compared to 71.0% in September 2022, 73.9% in October 2021, and 83.6% in October 2019. This is the lowest reported performance since the collection began. The 95% standard was last met in July 2015.’

’54.8% of patients were seen within 4 hours in type 1 A&E departments compared to 56.9% in September 2022, 61.9% in October 2021 and 74.4% in October 2019. This is the lowest reported performance since the collection began.’ (Type 1s are consultant led, 24 hour emergency departments, what most people would recognise as ‘A&E’. The equivalents in Scotland are the ‘main sites’.)

On longer waits in England: ‘There were 151,000 four-hour delays from decision to admit to admission this month, which compares to 121,000 in October 2021 and 80,100 in October 2019. This is the highest reported number since the collection began.‘

‘Of these, 43,800 were delayed over twelve hours (from decision to admit to admission), which compares to 7,058 in October 2021 and 725 in October 2019. This is the highest reported number since the collection began.’

Note, these long wait figures don’t include waiting time from arrival at A&E reception until the ‘decision to admit’ is made. NHS England re-sets the clock part way through the process: NHS Scotland does not.

How is the BBC reporting this?

Well, it did finally get round to covering these latest figures. For example, an article appeared on the BBC News website today around mid-day entitled ‘Record numbers faced four-hour A&E waits in England in October’ (https://www.bbc.co.uk/news/health-63583751).

Notably, this appears in the ‘health’ section of the website but as best as I can ascertain NOT on the main ‘UK’ news page, NOT on the ‘England’ news page, and NOT in the ‘politics’ section.  That is the first contrast with the reporting of the equivalent news about NHS Scotland: here it would be placed prominently in the main Scotland section and the Scotland politics section!

There are a few other notable aspects of the BBC article on NHS England’s A&E performance.

It states: ‘More than 550,000 patients were waiting more than four hours in major A&E units, up from 492,000 in September – the highest proportion on record.’  Let’s be ‘picky’:  as we don’t know how many attendances there were from this sentence, the use of the term ‘proportion’ here seems out of place.

And later we read this: ‘The proportion of all patients in A&E and minor injury units being seen, discharged or admitted within four hours fell to 69% in October, down from 71% in September, and well below the 95% NHS target.’

Now we know from NHS England that this 69% figure is the worst on record (see above). But note the shift in the nature of the units being referred to in the BBC article – from ‘major A&E units’ to ‘A&E and minor injury units’. This matters because NHS England reports on three quite different categories of facility, Types 1, 2 and 3. It is the major or Type 1 units that most people would recognise as an A&E department: it is only the performance of the ‘main’ A&E departments in NHS Scotland – the equivalent of England’s Type 1s – that the BBC reports. From the October statistics for NHS England, we learn that just ‘54.8% of patients were seen within 4 hours in type 1 A&E departments .… This is the lowest reported performance since the collection began.’

The 54.8% figure is never mentioned in the BBC article! Why? This has long been the most commonly used metric by the BBC in Scotland. Might it be too easy to draw unfavourable comparisons?

Other features of the BBC article are noteworthy.

Firstly, there is nothing political here: there are no references to, no quotes from,  opposition politicians. There is nothing about terrified patients at A&E (cf. Tory MSP Sandesh Gulhane) and no calls for a minister to resign (cf. Labour MSP Jackie Baillie). Why? Is it that opposition parties simply do not provide statements on England’s A&E waiting times to the BBC or they do but the BBC doesn’t use them? Does the BBC not ask opposition politicians for a comment? Whilst there is no reference whatsoever to a government minister – did the BBC not ask for a Westminster government response? – there is this:

‘Prof Sir Stephen Powis, NHS England’s medical director, said: “There is no doubt October has been a challenging month for staff who are now facing a tripledemic of Covid, flu and record pressure on emergency services with more people attending A&E or requiring the most urgent ambulance call-out than any other October.’ Not politicised: leave an NHS senior manager to explain, to justify!

And finally, there are no quotes from the Royal College of Emergency Medicine (RCEM) making reference to ‘unnecessary deaths’ due to long waits. An RCEM spokesperson typically gets quoted in BBC articles on NHS Scotland. There is only a very much milder quote from the president of the Society for Acute Medicine.

For perspective

The BBC article on NHS England provides this ‘useful’ information to the readership: ‘The most recent weekly data from Scottish hospitals also showed record numbers of patients having to wait in A&E before being treated, admitted or discharged.’ Not sure BBC articles on NHS Scotland provide comparable ‘assistance’ to readers!

Of course, this is far from giving a reasonable, balanced picture. The latest NHS Scotland A&E waiting times performance referred to here is this: 63.1% of patients were treated and either admitted, transferred or discharged within the four hour target time.

Of course, 63.1% is not good but it is 8.3 percentage points better than the latest NHS England figure of 54.8%. And that means that NHS Scotland’s performance is once again much better, c.15% better!

The lesson from all this is crystal clear. Stay alert when the BBC reports!