Yahoo News NHS crisis: How is the health service in your local area performing this winter?
New data shows that GP waiting times fell in December for the second consecutive month, with the share of people managing to secure an urgent appointment on the same day rising from 69% to 74%.
That's precious good news for the NHS, which is currently enduring its most difficult winter on record. The health service only began publishing data on GP appointments in September, so it's not possible to say how the current waiting times compare to previous winters.
Any improvement, however, will ease the burden on patients currently facing record waiting times elsewhere in the health service.
You can see how your health service is performing using the tool below.
The national picture
After securing a referral from their GP, many patients in England are being left waiting months to see a consultant.
As of November, 40% of patients seeking a diagnostic test were being forced to wait more than four weeks, with 13% waiting for over 12 weeks. Such long waits were practically unheard of before the COVID pandemic.
Diagnostic waiting times are longest in Lincolnshire, where nearly two in five patients (37%) wait more than 12 weeks for a test in November. That includes 81% who waited more than 12 weeks for a bone density scan, and 78% who waited over 12 weeks for an echocardiogram.
It is in emergency departments, however, that the crisis in the NHS is most visible.
Most critical incidents
Ambulances are supposed to reach the most critical incidents, which require immediate intervention or resuscitation, within seven minutes. That target has not been met since April 2021.
In December, it took ambulances in England an average of 11 minutes to reach such calls - a minute longer than the previous record, set in October.
Response times were slowest in the South West, where ambulances took 13 minutes on average to reach such cases, nearly twice the target.
Less urgent situations
Waiting times are even worse for slightly less urgent, but still life-threatening, situations such as heart attacks and strokes.
Ambulances are supposed to reach such calls within 18 minutes. As of December the average response time stood at 93 minutes, with 10% of callers waiting more than three hours and 42 minutes to be picked up.
In the South West, the average waiting time for such cases stood two hours and 39 minutes, with 10% of callers waiting over six hours and 39 minutes to be seen.
A spokesperson for the South Western Ambulance Service told Sky News that health and social care services are "under enormous pressure".
"Our ambulance clinicians strive every day to deliver their best care for patients, but our performance has not returned to pre-pandemic levels, partly due to handover delays at emergency departments," the spokesperson said.
'Handover times over three hours'
Ambulances in England spent 143,000 hours waiting outside hospitals in November, with 11,391 handovers taking more than three hours, according to data from the Association of Ambulance Chief Executives.
Those delays have improved in recent weeks, but remain at record levels for this time of year. One in five ambulance handovers (20.2%) took more than 30 minutes during the week to 22 January, compared to 18.3% during the same week in 2022 and 11.7% in 2020.
Lengthy handover delays are the result of backlogs within emergency departments themselves.
The time it takes to get through England's Type 1 A&E departments, which treat the most severe cases, has never been longer.
The chart below shows the share of A&E attendances lasting more than four hours each month. Every month in 2022 saw a new record broken, with more than half of attendances taking over four hours for the first time ever in December.
Other nations in the UK collect data for all A&E departments together, including minor injury units and specialist services. In Scotland's Forth Valley, 62% of attendances lasted more than four hours - twice the British average.
That data includes people who attended A&E but didn't need to be admitted. For those who do need a bed, the waits are far longer.
One in every three people admitted to England's A&E departments this December (33%) had to wait at least four hours between the point at which a clinician decided to admit them, and the point at which they actually got to a bed, with 11% waiting for over 12 hours.
In 2015, by comparison, just 8% of patients endured "trolley waits" of more than four hours, with fewer than 0.01% waiting more than 12 hours.
As of December, three of the five NHS trusts with the longest trolley waits were in London, with Croydon and North Middlesex trusts both seeing more than a third of patients wait over 12 hours. By far the longest waiting times, however, were in East Cheshire NHS Trust, where more than half of people admitted (52%) waited more than 12 hours for a bed.
Bed shortages
The government has previously identified bed shortages as a key cause of long A&E waiting times. The UK has long been unusual by international standards in how full its hospitals are, but in recent years the situation has become critical.
Every winter, the share of beds occupied has been rising: from 87% in 2020, to 90% in 2021, to 94% in 2022.
According to the National Audit Office, bed occupancy above 85% "can lead to regular bed shortages, periodic bed crises and increased numbers of hospital-acquired infections".
As of December, 92% of trusts had occupancy rates above this threshold - up from 64% in December 2020.
That includes the George Eliot Hospital NHS Trust in Nuneaton, which has been at 100% occupancy for general and acute beds since April. The trust's chief operating officer told Sky News that demand had been "exceptionally high" in recent months.
For other trusts, bed shortages are concentrated in particular types of care. Manchester University hospitals have been at full capacity for paediatric critical care since October, while neonatal critical care beds have been fully occupied in Oxford University hospitals for more than a year.
The total number of NHS beds has halved since 1987, as successive governments sought to cut costs and improve outcomes by moving certain types of care out of hospitals and into the community.
That strategy has been undermined in recent years by large cuts to local authority budgets. Over the past decade, the number of care home beds per person aged over 75 has fallen by 17%, according to government data.
With analysis from the King's Fund and the Health Foundation, Sky News is launching a new year-long project to examine the NHS at 75, the problems it faces and the potential solutions.
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
