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Government’s plan to scrap four-hour target ‘puts patient safety at risk’

Easing emergency department target sends signal that waiting times don’t matter, RCN warns

Easing emergency department target sends signal that waiting times don’t matter, RCN warns


Picture: Charles Mulligan

Government plans to scrap the four-hour emergency department target will put patient safety at serious risk, royal colleges have warned.

The RCN and the Royal College of Emergency Medicine (RCEM) criticised the lack of consultation on the idea, adding that the current target is evidence-based and 'not arbitrary'.

The government's plan was confirmed yesterday by NHS England chief executive Simon Stevens. He told the Commons health and social care committee the target would be 'significantly altered' and new clinical targets introduced on a trial basis next year, before being rolled out if effective.

Figures well below current target

The current target is that 95% of emergency department patients should be seen within four hours of presenting. However, it has not been met since July 2015. In December last year, 86.4% of people were seen within the four-hour target.


The RCN's Anna Crossley: 'Tinkering
with targets is the wrong approach.'

RCN professional lead for acute and emergency care Anna Crossley said it was 'imperative' that hospitals had staff and resources to give timely care within current guidelines.

'Tinkering with targets to make them easier to hit is the wrong approach,' she warned. 'Axing [the target] or loosening it without evaluating alternatives puts patient safety at risk and sends a terrible signal that waiting times do not matter.'

Ms Crossley added that nurses should be involved in any substantial reconfiguration of the standards.

 ‘Near-catastrophic impact on patient safety’

RCEM president Taj Hassan said: 'In our expert opinion scrapping the four-hour target will have a near catastrophic impact on patient safety in many emergency departments that are already struggling to deliver safe patient care in a wider system that is failing badly.’

NHS England medical director Stephen Powis said the review of standards is being 'clinically led' and that the organisation was working with the Academy of Medical Royal Colleges, Healthwatch England and others on any changes.

Professor Powis said: 'Any recommended changes will be carefully field-tested across the NHS before they are implemented.'

He said he would welcome views from a wide range of staff working in emergency care.


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