NHS chief ’s cure for worst A&E performance ever: drop the targets

NHS targets “have had their day”, the head of the health service has said – on the day A&E performance slumped to its worst level on record.

Lord Prior, the chairman of NHS England, signalled plans to abolish the key measure, as records showed just 84.4 per cent of patients were treated or admitted in four hours, against a 95per cent target.

The performance for January was the worst since the target was introduced in 2004.

Lord Prior – a former health minister – yesterday suggested central diktats had damaged patient care, encouraging “gaming” so that NHS trusts could appear to perform well, instead of prioritising patients for clinical reasons.

“We have had 15 years of this topdown, target-driven culture that has driven the NHS. The degree of pressure to hit targets is something I have never encountered in the private sector, the unnuanced level of these targets. Of course, the gaming that has developed around these targets and the bad behaviour … go to any A&E department and everyone measures the time … you get to three hours and 55 minutes and all hell hits.

“Everyone runs around like headless chickens to get them out or get them through or discharge them before the four hours,” he told an event hosted by the Reform think tank.

“Targets have had their day I think,” he said. “They have encouraged this top-down, hierarchical control in the NHS which has been very damaging for the culture, and very bad for getting clinicians involved and engaged.”

The Tory peer also said that attempts to encourage competition within the NHS had been “deeply damaging” and had “failed almost totally”.

NHS England is currently reviewing its clinical targets, including the requirement that 95 per cent of all patients attending A&E are treated, admitted or discharged within four hours.