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Readers’ panel: Should the four-hour A&E target be scrapped?

Amid unprecedented winter pressures, health secretary Jeremy Hunt recently suggested that the four-hour waiting time guarantee should no longer apply to patients attending A&E with less serious problems. Nursing Standard panellists have their say. 

Amid unprecedented winter pressures, health secretary Jeremy Hunt recently suggested that the four-hour waiting time guarantee should no longer apply to patients attending A&E with less serious problems. Nursing Standard readers have their say 


Should four-hour targets be scrapped for non-urgent cases? Picture: Solent News Agency

Pete Hawkins is a staff nurse in an emergency department in Bristol

Pete Hawkins

The government is in denial over the real issues causing unacceptable conditions for both patients and staff in emergency departments nationwide, namely the exit block from A&E due to ongoing cuts in social and primary care. This prevents timely discharge from hospital.

Health secretary Jeremy Hunt’s suggestion of revising the four-hour target is just an evasion. The target can work as a valid clinical marker, but without patient flow it becomes ineffective. Exit block should be the focus, not fiddling statistics and numbers to suit.


Daniel Athey is a staff nurse on an acute medical unit in Sheffield 
@danjathey 

Daniel Athey

While I think the target should be scrapped, my question would be why now? The four-hour wait encourages medical decisions to be rushed and is influenced by non-clinical factors. But it is a constraint that emergency deparments have learned to work with, and scrapping the target during a crisis feels like sweeping the problem under the carpet.

Removing and disregarding a measurable target – one that has been missed across the country – feels like an underhand tactic to me. 


Liz Charalambous is a staff nurse in Nottingham
@lizcharalambou 

Liz Charalambous

Hospitals are full and staff are exhausted. Sending Jeremy Hunt to fix this by scrapping the four-hour A&E target is akin to an incompetent mechanic tinkering under a rusty car bonnet when the wheels are falling off.

Only adequate funding and a systematic, comprehensive approach will fix our NHS. This means looking at health care in its entirety, not just focusing on emergency services. A quick fix simply will not do. We need a government that values the health and well-being of the people of this country. 


Edwin Chamanga is a tissue viability service lead in London 

Edwin Chamanga

Increased demands on the provision of healthcare services are to be expected with people living longer, and winter pressures have put emergency departments under significant strain of late. But one of the root causes of the failure of many hospitals to meet the four-hour A&E target is a shortage of beds, with patients having to stay longer in the department until a bed can be found.

The four-hour target should be maintained as a performance indicator, but issues around bed shortages need to be addressed urgently. 


Readers' panel members give their views in a personal capacity only 

 

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