England could be about to face its worst ever winter for A&E waiting times.

Independent charity the Health Foundation has estimated that it would take an extra £360m (€400m) to ensure the national four-hour A&E waiting time target was met nationally throughout the January to March quarter – but says it may already be too late to have any effect.

The Health Foundation predicted:

  • About 5.8 million people will attend A&E this winter (January to March), a 12% increase from winter 2010/11. Although this is less than in the previous quarter (5.9 million), the people who come through the door in winter are more likely to be admitted.
  • Around 735,000 people will wait longer than four hours, which is 311% higher than in the winter of 2010/11.
  • This means just 87% of people will be seen and treated within four hours, which falls short of the 95% target and could be the worst quarterly performance on record.
  • Around 173,000 people will wait at least four hours between the decision to admit and admission, often spending this time on trolleys. This is a total increase of 414% since 2011/12.

The charity's £360m figure was a minimum estimate of what would be needed to increase both A&E and inpatient capacity to meet the four-hour target this winter.

Adam Roberts, head of economics at the Health Foundation, said: "With the temperatures already dropping, it is almost certainly too late to invest wisely in schemes to improve NHS performance this winter. But without at least some level of additional investment, it is hard to imagine how additional capacity can be found to improve access for patients who need emergency care this winter, next winter and beyond.

"Any additional investment would be welcome for this year, but a long-term plan needs to be developed as soon as possible for next year and those after. Winter is not going away."

The Health Foundation has raised fears for A&E waiting times this winter. Getty

In response to the new research, a Department of Health spokesperson said: "Thanks to the hard work and dedication of NHS staff, A&E performance has improved and nine out of 10 people were seen within four hours in A&E in October; more than 60,072 a day.

"Whilst we fully expect the NHS to continue to face pressures as part of winter, the Health Foundation itself points out that the NHS has more robust plans in place than ever before, including an unprecedented system-wide push for all NHS workers to have the flu jab, supported by an extra £100m of additional funding for A&Es and £1bn more funding for social care this year."

The NHS released a wave of winter funding this year, after the Chancellor's Spring Budget outlined £100m of capital funding for A&E departments to ease pressure at this time of year. In September, £13m was awarded to 19 hospitals to improve patient flow through A&E, ensuring departments are prepared for busy times during winter by investing in necessary equipment or infrastructure.