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Following the worst figures on record this winter, Health Secretary Matt Hancock has signalled that four-hour waiting targets for A&E are likely to be scrapped for the NHS in England.
Saying it would be better if targets were ‘clinically appropriate’ and the ‘right targets’, Hancock defended the NHS’s failure to meet the standard that 95 per cent of patients attending A&E should be admitted, transferred or discharged within four hours.
A decision about the flagship four-hour target is due to be taken by NHS England in the coming months, after plans were revealed last March to pilot changes that would prioritise patients with serious conditions while patients with minor problems could wait longer than four hours.
In total, 98,452 patients spent at least four hours on a trolley in A&E as they waited for a bed this winter. In December, hospital-based A&Es treated and then admitted, transferred or discharged 68.6 per cent of arrivals within four hours, representing the smallest proportion in any month since the target was created in 2004 and the first time performance has slipped below 70 per cent.
Speaking to BBC Radio 5 Live, Hancock said: “We will be judged by the right targets. Targets have to be clinically appropriate. The four-hour target in A&E – which is often taken as the top way of measuring what’s going on in hospital – the problem with that target is that increasingly people are treated on the day and unable to go home. It’s much better for the patient and also better for the NHS and yet the way that’s counted in the target doesn’t work. It’s far better to have targets that are clinically appropriate and supported by clinicians.”
The government’s new NHS bill is promising an extra £33.9 billion a year by 2024, and Hancock believes that the biggest cash increase ever for the health service is the best way of dealing with waiting time deterioration.
Rachel Power, the chief executive of the Patients Association, warned that any dilution of the four-hour wait would be ‘premature and unjustified’. She said: “We would be greatly concerned about what it would mean for patients, and whether it might be happening simply to disguise a collapse in NHS performance due to unnecessary long-term underfunding, avoidable workforce shortages and predictable growth in patient need.”
Mid Cheshire NHS Trust’s ageing IT estate was causing significant problems. Amy Freeman, the Trust’s Associate Director of IT, identified a number of challenges that needed to be addressed when she joined the organisation in 2016.