Four-hour A&E wait target could be scrapped

Henrietta Strickland
March 13, 2019

The plans from NHS England would see new waiting time targets set for the initial assessment of patients, "rapid" treatment of the most seriously ill including those with mental health conditions, and an average time for all patients replacing the four-hour standard.

Since ending the four-hour target was first mooted it has raised fears that it could lead to patients being left untreated for hours, and concern that the move might be motivated by political expediency rather than patient safety.

The target, introduced in 2004, was met by just two hospital trusts last month, and NHS bosses have blamed the model for distorting priorities with a large number of patients being admitted to hospital just before the four-hour mark.

NHS England believe that the targets were outdated and plan to reorganise how patients are dealt with.

"Robust joint evaluation of any new measures will need to be developed to ensure that any potential change can prove more effective and safer than the existing arrangements before they are adopted".

Dr Nick Scriven, president of the Society for Acute Medicine, said the organisation had been calling for change since 2016.

The plans also aim for people with suspected cancer to receive a definitive diagnosis within 28 days of urgent referral by their GP or a screening service as part of the proposals, which will be trialled by the NHS, however, details of where this trial will take place have not yet been published.

"I agree that the A&E target is overdue a check-up: it has started rewarding the wrong behaviours, like moving patients just to stop the clock".

"Given the history of targets having unintended consequences, we will need to watch closely as these trials go ahead, looking at the actual effect on people's health as well as access to care".

"With these proposals representing a shift to instead give reassurance of a 28-day wait for diagnosis, it's vital we ensure they will further improve patient experience and build on years of progress".

"Due to social care funding being cut, the numbers visiting A&E has soared nationally", he said.

"However, it's hard to see exactly how it will be possible to meet these new more stringent standards without more staff - or they would already be taking these sensible measures".

The decision to ditch the four-hour target is likely to be the most controversial measure. If the NHS is to focus on ways to save lives that is what we should be measuring.

He later added: "As one of the secrets behind the best performing A&E in the country, our GP's see patients and educate them on conditions to avoid frequent re attenders as they are signposted to be treated by the right person, at the right time".

Other reports by Click Lancashire

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