Hospital admission rates have increased by 5.5 per cent year on year. This reflects a longer term trend of admissions increasing in excess of population growth.
Most recent data show a 5.5 per cent year on year increase in the number of elective hospital admissions in London. GP referrals also show increased demand in the long-term, although the year on year was just 0.9 per cent. Both GP referrals and elective admissions to hospitals can be used as proxies (albeit not perfect ones) for population health, and both indicators have been running ahead of overall population growth in recent years.
A major factor in both these rises are the increasing number of older people in the capital, who are more likely to be in worse health and need more complex treatment; 39 per cent of people treated in London hospitals were over 60 (over 1.1m cases) in 2015/16.
The proportion of A&E admissions taking more than four hours from arrival to admission, discharge or transferal has risen slightly, by 0.24 percentage points, compared to the same month last year, though the overall trend has been upwards.
A&E performance targets have changed twice in recent years. From March 2010, the target was to see 95 per cent of attendees within four hours of admission, but since July 2016, different operational targets have been employed for NHS providers, although the 95 per cent indicator remains the headline. A recent report suggests longer waits relate to age and morbidity factors, along with financial and capacity constraints of hospital departments.
A&E attendance rates have remained relatively constant over the last year, with a latest three month average of 391,605 admissions in April.
The past three months have shown a mixed picture of air pollution in London. This follows a particularly bad winter for air quality: November, December and January saw large increases in nitrogen dioxide (NO2) and particulate matter 10 (PM10) (both roadside and background) levels compared to the corresponding month in the previous year.
Nitrogen dioxide levels in June are significantly down for both roadside and background measures both compared to the 2010-17 monthly average and to the same month last year. Roadside PM10 levels are below the long-term average and about the same level as last year. However, background levels are actually higher than both the average and the levels recorded last June. These trends demonstrate the complexity in understanding London’s air quality – it is improving in terms of nitrogen dioxide, but largely worsening in term of particulate matter.
Pollution concentrations in London are influenced by the weather and early 2017 has seen severe pollution episodes every month starting with the worst episode in years occurring between 20th and 27th January. These ‘episodes’ occur because pollution from outside the city adds to the pollution that Londoners are producing each day. The introduction of more control measures to reduce London-generated pollution (like the ultra-low emission zone) although important will not, alone, solve London’s pollution problem. This will require national action and even international action by our neighbouring countries to achieve the clean air and blue skies that we desire.
Frank Kelly, Professor of Environmental Health, King’s College London, Commissioner on Centre for London’s independent Commission on the Future of London’s Roads and Streets