The four-hour A&E target may be dropped under plans announced by NHS England.
NHS bosses have revealed their plans to drop the A&E target alongside changes to waiting times for cancer, mental health and planned operations. It said the targets were becoming outdated, this comes after many of the targets have been missed over the years.
Instead of them aiming to see and treat patients in four hours the sickest patients will be prioritised for quick treatment. NHS England are wanting to see patients coming in with heart attacks, acute asthma, sepsis and stroke starting their care within an hour. These changes will be tried this year and if everything is successful it could be introduced in 2020.
The four-hour target was introduced in 2004 and expects 95% of patients to be treated in time but it has not been met since July 2015. In the last month only two trusts hit the target. Around a fifth of all emergency admissions from A&E happen in the final 10 minutes before the deadline.
NHS England said hospitals were more motivated by the target rather than doing what was best for the patients.
The NHS will move towards average waiting times for planned operations such as knee and hip replacements, Currently 92% of patients should be seen in 18 weeks but it has not been met since February 2016.
People with suspected cancer will receive a definitive diagnosis within 28 days of urgent referral by their GP or a screening service as part of the proposals.
Patients experiencing mental health crisis will also be able to access quick care in their own home or community, while no one who urgently needs help will wait more than 24 hours.
Professor Stephen Powis, the NHS in England’s national medical director and leader of the review, said: “The NHS is aiming to improve care for patients and save hundreds of thousands more lives over the coming years, with greater access to mental health support, better treatment for the major killer conditions and services which are more joined-up, personalised and closer to home.
“So, 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 that they take account of the latest treatments and techniques, and support, not hinder, staff to deliver the kind of responsive, high-quality services that people want to see.”
Professor Ted Baker, chief inspector of hospitals for the Care Quality Commission, said: “The four hour A&E standard has been valuable in focussing efforts on improving emergency care but if we are to continue to improve patient safety and ensure every patient gets the priority they individually need it must be reformed and we must find better measures to ensure patient safety.
“Emergency departments need a set of standards which gives priority to patients with life-threatening conditions, ensures people get care in a timely way and puts pressure on the whole hospital to end long corridor waits for those who need admitting. We are confident that field testing these proposals is the safest and most effective way of improving care.”
Healthwatch National Director Imelda Redmond said: “What shapes people’s experiences of A&E is often not how long they wait, but the quality of care they receive and how that care is delivered.
“People’s experience of care can therefore be significantly improved by staff carrying out quick initial assessments to reassure patients, prioritising those in greatest need and concentrating on communication to keep people updated on progress. This is of course what doctors and nurses working in A&E want to do all the time, but current targets sometimes draw attention away from this.
“When the four-hour target was introduced in 2004 it helped to significantly reduce the lengthy waits faced by many patients. But 15 years on the NHS faces different challenges, and from what people tell us it is clear that the time is right to look again at this core measure.
“Over the next few months Healthwatch will be supporting NHS England as they test new measures of waiting times in A&E to ensure they have a positive impact people’s experiences of care, as well as on clinical outcomes and patient safety.
“Ultimately we want to see targets free up hard working A&E departments so they can concentrate on delivering the best possible care for their patients.”
