A new report suggests that the number of patients forced to wait in accident and emergency (A&E) departments for more than four hours before receiving treatment, has hit its highest total in a decade. The four hour target was first implemented by the Labour government back in 2003/04. Research carried out by health think tank The King's Fund indicates that between October and December 2012, around 232,000 patients were waiting for more than four hours – equivalent to 4.3% of all the patients at A&E wards around the country. Although technically still reaching the government's aim of 95% of patients being attended to in that time, it seems the situation has been getting steadily worse over the last few months. The 95% target was reduced from 98% by the Coalition government who argued it enables doctors the facility to more efficiently study and treat complex cases and less urgent cases are not prioritised over the more serious ones. The 232,000 patients stuck waiting for over four hours is a 21% increase contrasted against the same time period in 2011 and represents the highest number for those particular months since 2003. In the report, it says: “The proportion of patients waiting more than four hours from arrival in A&E to admission, transfer or discharge in the third quarter of 2012/13 (October to December) rose by 21 per cent over the previous year and 38 per cent on the previous quarter. Nevertheless, overall, the NHS remained within target on this waiting times measure – although around a quarter, or 65 trusts recorded breaching the target during this quarter affecting more than 232,000 patients.” Commenting on the findings, Professor John Appleby, Chief Economist at The King’s Fund said: “This is probably a combination of factors. By relaxing the target, the system will move towards that new relaxed level and is readjusting, plus demand is rising for A&E attendances and if the rest of the hospital is under pressure, and cannot discharge patients as quickly, you get a blockage in A&E. It doesn't take much for things to start to go wrong. The percentages may look small but it is affecting a lot of people now. 232,000 in that quarter so nearing a million if that were repeated year round. Also the numbers of trusts it is affecting is increasing showing it is no longer just a problem for a few trusts.” Some of the key points of the report were: . Many patients who required admittance onto a ward were actually just being left on trolleys for long lengths of time. . A survey of NHS finance directors found many were concerned about budgets, with a third complaining that the quality of patient care in their area had deteriorated in the previous year - double the number of those who had similar claims in the last survey. . Around a quarter of all the countries hospital trusts have reported failures in meeting the A&E target - showing that the issue urgently needs addressing. Prof Appleby added: “The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer. For social care, it will be increasingly difficult for councils to make further savings without directly cutting services or affecting quality. Health and care services have coped well until now, but it is clear that many organisations expect things to become much more difficult over the coming year.” Health Minister Lord Howe also spoke on the report and said: “Patients need to be able to rely on prompt, high quality, urgent and emergency care and treatment. We are clear that patients shouldn't face excessive waits for treatment. Where there is extra demand on services, hospitals and staff need to work together to ensure that patients get the care they need.”