Lengthy A&E waiting times are just one symptom of an increasingly overstretched NHS. And the standards set in place to try and reduce those waiting times appear to have become largely ineffective. The four hour target, aimed at ensuring that 95% of A&E patients are treated, admitted or sent home within a four hour window hasn’t been met nationally since 2015 and performance against it plunged to record lows this year. In response, and as a result of a clinically-led review of standards introduced by the Prime Minister last year, NHS England has announced that it will be piloting an alternative system of targets during 2019, with a view to scrapping the blanket four hour measure altogether.

Under the new plans, a rapid assessment measure for all patients arriving at A&E will be trialled, along with targets aimed at ensuring faster treatment for patients with the most critical conditions, such as heart attacks, sepsis, stroke and severe asthma attacks. A measure of average waiting time in A&E will also be tested as an alternative to the four hour standard. 

The NHS says the trials are backed by wide cross-section of medical leaders, patient groups and charities, but the Royal College of Emergency Medicine has asserted that it’s against the four-hour target being scrapped and wants it to work alongside the new measures. College president Dr Taj Hassan has said the institution is, “keen to ensure that any changes are not imposed due to political will, but are developed responsibly, collaboratively and are based upon clinical expert consensus in the best interests of patients."

It remains to be seen what the outcome of the new target pilot will be and we await further detail on how exactly the new measures will be evaluated and reported on but, already, a number of concerns spring to mind. In the absence of the four hour target applying to all A&E patients, for instance, where will the accountability to attend to patients who are viewed as ‘non-urgent’ come from? Is there a risk that they will receive a lesser standard of care due to not being a priority? Will these patients understand what sort of experience they should expect in A&E and how their local hospital compares to others?  And how, amongst all this, is the standard of A&E care being measured, rather than the time it takes to provide this care?

Time and time again, at Jackson Lees, our clinical negligence experts see harm caused to clients coming as a result of not being properly examined in A&E, or because a thorough medical history hasn’t been obtained or the right set of investigations applied. In some instances, junior staff have not been able to supply the level of expertise and knowledge required for patients, resulting in misdiagnosis. Greater scrutiny and measurement of standards of care could help to reduce the risk of mistakes being made – rather than a focus on timing.

NHS England says its new standards will be measured to ensure that, amongst other things, they promote safety and outcomes, drive improvements in patient experience and are clinically meaningful, accurate and practically achievable. Hopefully, the pilot tests will demonstrate how this will work in practice and we look forward to seeing how they progress – provided they do not compromise accountability and public scrutiny. 

For a free consultation with one of our A & E Claims specialist advisers, call us on 0800 387 927, request a callback at your convenience or message us your enquiry. You can also drop into the clinic at our Birkenhead office Monday to Friday, 9am to 5pm.