Four-hour A&E target may be scrapped by NHS

Plans to axe the four-hour target currently in place in A&E departments across the country have been unveiled by NHS bosses this week.

At present, NHS hospitals aim to see 95% of all patients visiting Accident & Emergency departments within an average time of four hours. This target, introduced in 2004, has not been met since 2015 and there are fears that hospitals are motivated by this target rather than doing what is best for the patient.

According to NHS England however, the new target will aim for those suffering with heart attacks, acute asthma, sepsis and strokes to be prioritised and seen within an hour.

Changes to waiting times for planned operations, cancer and mental health are also being revised, after the Prime Minister called for a review into NHS England’s targets last year.

Average waiting times for planned operations such as knee and hip replacements will be introduced – the current target is for 92% of patients to be seen within an 18-week period and has not been met in over 3 years. Cancer targets will be also simplified. The NHS plan to introduce two key targets for treatment (not currently measured), which will start on top of the incoming ’28-day goal’ for cancer diagnosis.

In terms of mental health care, new targets will be introduced with the aim of ensuring that individuals who require urgent crisis care within the community will receive this in 24-hours. Furthermore, access to other community mental health services will be expected in four weeks, for both adults and children.

Stephen Powis, medical director for NHS England, has welcomed the review and said:

"Now is the right time to look again at the old targets, which have such a big influence on how care is delivered, to make sure they take account of the latest treatments and techniques and support, not hinder, staff to deliver the kind of responsive, high-quality services that people want to see."

Pilot trials will take place throughout the rest of 2019 and if successful, the changes could be introduced as early as 2020.

Helen Dolan, partner and clinical negligence solicitor here at PRD, comments:

Although the four hour target was introduced fifteen years ago, we are all familiar with news headlines telling us that the NHS consistently fail to meet these. The NHS are now proposing to review the target and to ensure that patients with serious acute conditions are seen within an hour; I may be missing something but each hospital already has priority categories (colour coded or numerical, known as 'A&E Initial Assessment Triage Categories') which provides for a one hour target for the critically ill. I am unclear how this review will improve care for those patients.

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Helen Dolan is a Senior Partner and Head of Clinical Negligence here at Potter Rees Dolan. Should you have any queries about clinical negligence issues, or indeed any other aspect of this article and wish to speak to Helen or any other member of the team, please contact us on 0161 237 5888 or contact Helen directly.

Source: BBC News; NHS