Hospital Dr News

Medical profession skeptical over Government’s motives to change NHS targets

Medics have reacted angrily to the Health Secretary’s hints that existing clinical targets are to be scrapped – including the four-hour waiting time measure in A&E.

Hospitals must aim to ensure 95% of patients are seen within the time limit, but this winter few A&E units in England hit the target.

Matt Hancock told BBC Radio 5 Live recently that ministers should be judged by “the right target” and a “clinically appropriate” one was needed.

Doctors fear that the Government is seeking to establish targets that are politically less damaging. While many feel the A&E target is not perfect, it does drive productivity in hospital systems.

Labour’s shadow health secretary, Jonathan Ashworth, said changing targets “won’t magic away the problems in our overcrowded hospitals, with patients left on trolleys in corridors for hours and hours”.

Waiting time targets were put under review by Theresa May in 2018.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson, said: “We agree with trying to improve on the standard and have been happy to explore alternatives that drive patient flow and improve experience.

“However, so far we’ve seen nothing to indicate that a viable replacement for the four-hour target exists and believe that testing should soon draw to a close.

“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”

NHS England’s review group under its National Medical Director Prof Stephen Powis is due to report shortly, with its recommendations being influenced by evidence from 14 NHS trusts that are trialling an alternative to the four-hour guarantee.

Hancock said: “We will be judged by the right targets. Targets have to be clinically appropriate.”

He also pointed out that moves towards delivering more ambulatory care weren’t acknowledged within the target.

Hospital performance against this target has been particularly poor this winter, with some trusts dealing with less than 50% of patients within four hours.

The target has been criticised in the past by physicians and commentators alike. The time guarantee has always meant patients might attend A&E with minor complaints rather than wait a longer time to see a GP.

However, doctors accept that it has improved care by ensuring that as far as possible patients – with potentially serious illnesses – are seen quickly.

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