All entries for Monday 14 March 2005

March 14, 2005

NHS Accident & Emergency Targets

Target putting A&E care at risk
Accident and emergency patients could be being put at risk by the need to meet the government's four-hour waiting target, senior doctors claim. Half the casualty units in England told the British Medical Association pressure to meet targets meant patients were moved inappropriately. Some 40% also admitted patients were discharged from A&E before they had been properly assessed or stabilised. But the government said the survey painted a "distorted picture". The government had set down a target which said that, by the end of December last year, 97% of patients should be seen, treated and discharged from A&E within four hours of being admitted. Half failed to meet the target.

From BBC News

It’s hard to understand the rationale behind all the targets handed out. If a patient currently waits 6 hours on average before being attended to, how does assigning an arbitrary value of 4 hours help matters? A new target doesn’t alter the funds available. A new target doesn’t increase recruitment, nor relieve the stress and tiredness of existing staff. Targets seem to yield greater benefits to those employed to create them than to the public putting up with the service. I’m all for collecting data on hospitals in order to gauge performance over time, but no two hospitals are identical in their resources, strengths and weaknesses. By setting targets applicable to everyone the government simply creates incentives to meet targets in ways which may prove detrimental to patients. i.e. through early discharge. Do NHS management seriously think those who’ve dedicated their careers to saving lives will hold patients in A&E wards any longer than is necessary just to avoid extra work?

I suppose the more targets one creates, the greater the chances of some actually being met. And if you’re a government pouring funds into an institution, you’ve got to have some ‘proof’ that the spending has been fully justified.

March 2005

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