NEW figures have revealed the struggle facing Wirral's NHS services – with A&E, cancer waiting times and ambulance response targets not being met.

A review of Wirral Clinical Commissioning Group’s performance against national standards uncovered a number of concerns including the borough’s accident and emergency department at Arrowe Park Hospital, which it was claimed on Tuesday has seen a "deterioration in the performance of the whole system".

Some treatment referral times have not been met for over three years, the report showed.

The figures were discussed at Wirral Health and Care Commissioning (WHaCC)'s governing body meeting at the Lauries building in Birkenhead.

Despite concerns, positive aspects of performance were also raised – as well as the work being done to combat the problems.

Here are five service areas highlighted during the meeting:

1. A&E

Perhaps of most concern at the meeting was the figures surrounding A&E raised by Nesta Hawker, director of commissioning and transformation.

Her report said the standard expected of A&E services across the country is for 95% of patients to be seen within four hours.

But in October and November, the report said the combined A&E performance at Arrowe Park Hospital, as well as the facility’s walk-in centre, fell well below national standard. In October the figure was 77.8% and November 75.2%.

Despite that, the figures did exceed an agreed improvement plan.

Speaking at the meeting, Ms Hawker said: “In terms of A&E, there’s been a deterioration in the performance of the whole of the system.”

The report added: “The NHS England have acknowledged the pressure on all systems to deliver the 95% standard and have requested systems prioritise delivery of ambulance handover and turnaround, and super stranded patients (those patients with a hospital stay in excess of 21 days).”

Despite the concerns, members heard progress had been made since the report, including more patients being streamed to primary care and an improved performance in helping analyse arising issues.

In terms of further priorities to address the problems, the report said they included a “new approach” to super-stranded patients, and more support for patients already inside the emergency department.

2. Ambulance response times

In terms of ambulance response times, while the service has been meeting few national standards, performance has improved.

In October, North West Ambulance Service (NWAS) achieved just one of six standards of response times, and in November, three.

The report described ambulance turnaround and handover as “extremely variable”, and a “clear risk” to patients.

Work is being done with NHS England to improve performance, the report added, as part of a “super six” action plan. And despite the figures, from October to November, performance improved almost across the board.

Ms Hawker said: “This performance shows that actually ambulance response times have all improved bar one. That’s really an important thing to note.”

3. NHS 111

The region’s helpline, run by NWAS, missed every performance standard in October and November, the report said.

It added: “[The service] struggled to meet the Key Performance Indicators (KPIs) in October and November.

“The main issues causing under-performance are recruitment, sickness levels, retention and training of call handlers and clinicians.”

But it did say “significant improvements” have been made in the past year, including calls answered in 60 seconds, abandoned calls and the mean answer time.

4. Referrals to treatment

The national standard for the number of people to wait 18 weeks or less for referrals is 92%, and in October and November, Wirral fell below that at 81.13% and 81.55%.

In fact, the report said the CCG has not met that national standard since December 2015, meaning longer waits for those with physical or mental health conditions.

But Ms Hawker maintained referrals for treatment was still a “positive story”, with Wirral’s performance continuing to improve, including 26-40 and 40-52 week waits.

5. Cancer waiting times

The CCG failed two performance standards in October and three in November for cancer waiting times, although the report said actions are “already in place” to improve the situation, including more meetings and tracking.