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Report by King’s Fund follows release of DoH figures that showed 48% increase in breaches of legally binding NHS targets The number of patients waiting more than the recommended maximum of 18 weeks for NHS treatment has soared by 48% since last year. Figures released by the Department of Health came as a separate report by the King’s Fund found that in more than 45 hospital trusts, more than 10% of patients were not admitted within 18 weeks of being referred by their GPs, breaching legally binding targets in the NHS constitution. The figures have more than doubled on the previous year. The report found that while the NHS overall had managed to meet targets on waiting times and infections despite hospitals having to find savings of between 6% and 7% this year, this masked “considerable variation” at a local level. Using government data, the Guardian found that 28,635 patients in England who were treated in an NHS hospital during August had been waiting more than 18 weeks, compared with 19,355 in the same month in 2010 – a rise of 48%. The King’s Fund, a leading health thinktank, concurred with this analysis, pointing out that “although average waiting times remain within target range, one in four hospitals failed to meet the target”. Rob Findlay, who runs NHS waiting times company Gooroo, pointed out that in St Georges, Kingston, Bath, Guy’s & St Thomas’, Sheffield and South London hospital trusts, there were “1,000 patients on waiting list for more than a year”. On this measure, the numbers waiting are the largest since the coalition came to power last year, when the health secretary, Andrew Lansley, reviewed or eased several NHS waiting time targets. One of the measures changed was Labour’s target that no one should wait more than four hours in A&E, with the threshold lowered from 98% to 95%. The King’s Fund found that 29 hospitals failed to meet that measure. In Surrey and Sussex Healthcare NHS Trust, a third of the 13,000 patients who used the hospital’s A&E ward waited more than four hours. The report also found that “45 hospital trusts reported higher levels of C difficile infections than the same period last year”. John Appleby of the King’s Fund said: “Infection rates are a indication of when hospitals are under pressure. As more patients go through the system, you end up with higher bed occupancy. This is when you can get higher rates of infection.” Appleby said a survey of 23 NHS finance directors had shown “15 are pessimistic about the financial state of their local health economy, with only three optimistic about this”. Most of the NHS finance directors questioned by the King’s Fund are “uncertain or concerned” about whether their trust will meet its savings target, with the majority expecting to face equally challenging targets of 4% or more next year. Appleby said: “We are seeing a minority of trusts are struggling to keep waiting lists down and reduce hospital-acquired infections. Looking ahead, the challenge will be to maintain performance and deliver productivity improvements as finances tighten further. “Six months into an unprecedented four-year period of financial restraint, the pressures already emerging in a small number of trusts highlight the scale of the challenge facing the NHS.” Katherine Murphy, the Patients Association’s chief executive, said: “The prime minister made a personal promise to ensure that the right to be treated within 18 weeks, enshrined in the NHS constitution, was upheld. He has utterly failed to live up to that promise.” A Department of Health spokeswoman said: “Waiting times are low and remain stable. But we know that, despite the increase in funding, the NHS needs to save up to £20bn from within its budget to meet future challenges. We are absolutely clear that this does not mean cutting services. This means getting better value for every pound spent in the NHS so that it can continue to improve and deliver services for patients every day.” NHS GPs Health Health policy Doctors Randeep Ramesh Denis Campbell James Ball guardian.co.uk