Four-hour A&E wait target could be scrapped

Modesto Morganelli
Marzo 14, 2019

The NHS review of clinical standards confirms that the NHS's flagship performance marker may be scrapped with changes to A&E targets accompanied by new plans for waiting times for cancer, mental health and planned operations.

NHS England said now one in five admissions from A&E happen in the final 10 minutes before the four-hour deadline, suggesting that hospitals are focusing on meeting targets "rather than what is the best approach for each patient".

The key target for routine surgery also looks likely to be scrapped as NHS England confirmed that it would test a measure of average waiting time in A&E as an alternative to the standard that 95 per cent of patients must be dealt with in less than four hours.

Just 84.4 per cent of patients were treated or admitted in four hours, against a 95 per cent target, meaning almost 330,000 patients waited longer than they should.

They will trial a rapid assessment measure for all patients arriving at A&E, with the intention of providing quicker life-saving treatment for those with conditions such as heart attacks, sepsis, stroke and severe asthma attacks, hopefully within an hour.

Healthwatch national director Imelda Redmond said: "What shapes people's experiences of A&E is often not how long they wait, but the quality of care they receive and how that care is delivered".

The proportion of people waiting more than 18 weeks for treatment is now at its highest level for a decade.

Around a fifth of all emergency admissions from A&E happen in the final 10 minutes before the four-hour deadline.

The pilot schemes aim for mental health patients attending A&E in crisis to receive emergency treatment within an hour.

People with suspected cancer would be given a definitive diagnosis within 28 days of urgent referral by their GP or a screening service.

Prof Powis said the service was "aiming to improve care for patients and save hundreds of thousands more lives over the coming years, with greater access to mental health support, better treatment for the major killer conditions and services which are more joined-up, personalised and closer to home".

It also proposes a new time standard, to measure how quickly all patients are assessed.

The proposals follow a clinical review of NHS targets that have been routinely missed for several years as demand has risen.

Nuffield Trust chief executive Nigel Edwards said: "NHS targets never work as expected in the real world, so the idea of testing out new proposals and carefully monitoring the effect on patients is a big improvement on the usual directive approach".

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