Axing A&E waiting time targets will cost lives, warn doctors
‘An excess of mortality’
SCRAPPING the four-hour waiting time target in A&E will lead to avoidable deaths, longer delays and overcrowded corridors, senior doctors said last night.
Their warning came after NHS officials announced a major review of waiting times in the health service that could lead to many of the current measures being replaced.
These include the flagship A&E target under which patients are meant to be seen and either sent home or admitted to a ward within four hours.
NHS England will instead begin trialling new standards whereby doctors will be told to assess the most serious cases – such as possible sepsis and heart attacks – within an hour of their arrival in A&E.
But those with less serious conditions – including fractures or abdominal pain – will inevitably have to wait much longer, in some cases well over four hours.
The target has not been met since July 2015 and yesterday’s announcement prompted accusations that bosses were simply ‘moving the goalposts’.
Leading A& E doctors, meanwhile, warned that scrapping the measure would hit patients. Dr Taj Hassan, president of the Royal College of Emergency Medicine, said there would be ‘very crowded emergency departments’ with higher rates of ‘mortality and morbidity’.
But NHS England said the target was outdated and encouraged staff to see patients just about to breach the fourhour wait ahead of more urgent cases.
Under the new system, to be piloted from next month, anyone with possible sepsis, heart attacks, strokes, severe asthma or trauma will have a ‘rapid assessment’ within one hour. Patients experiencing a severe mental health crisis will also be assessed within an hour, but everyone else will have to wait their turn.
NHS England is also considering scrapping the 18-week wait for routine operations and the two-week cancer wait, within which patients with symptoms should be seen by a specialist.
Professor Stephen Powis, the NHS in England’s national medical director, said: ‘As we build an NHS that is fit for the future, 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.’
But Dr Hassan, a consultant at Leeds Teaching Hospitals, said: ‘The four-hour standard provides the opportunity for the entire system to take responsibility. If you don’t have flow in the system you get a very crowded emergency department. That leads to an excess of mortality and morbidity.
‘The other unintended consequence is that you get more violence towards staff, verbal abuse and potentially physical abuse.’
Saffron Cordery, of NHS Providers, which represents hospitals, warned that current standards had ‘slipped’ and ‘we must guard against any sense of “moving the goalposts” to bring the standards back within reach’.
The new A&E measures will be tested in up to 20 hospital trusts. NHS England is hoping to decide in the autumn whether they will be rolled out nationally to replace the four-hour target.