'Target-associated' approach to A&E means doctors abandon new arrivals

‘Target-associated’ approach to A&E queue times means doctors are abandoning arrivals to see less serious patients who have been waiting nearly four hours, experts warn

  • A&Es seeing up to one in four patients within 10 minutes of the four-hour target
  • A quarter of cases at top trusts saw a patient being seen in last ten minutes
  • Experts say ‘target-associated’ approach could mean doctors abandon arrivals 

Some A&Es are seeing up to one in four patients within 10 minutes of the four-hour target in what is likely a bid to improve their performance rankings.

Analysis by the Health Service Journal yesterday revealed that almost a quarter of cases for the best performing trusts in rankings of the four-hour target included a patient being seen between three hours 50 mins and four hours.

Some A&Es are seeing up to one in four patients within 10 minutes of the four-hour target

Of the patients seen within four hours at Surrey and Sussex Healthcare Trust, Bradford Teaching Hospitals Foundation Trust and London North West University Healthcare Trust, 24 per cent of them were seen within the last 10 minutes.

Experts warned that this ‘target-associated’ approach could mean doctors are abandoning new arrivals in A&E to focus on seeing less serious patients who have been waiting three hours and 50 minutes.

Experts warned that this ‘target-associated’ approach could mean doctors are abandoning new arrivals in A&E to focus on seeing less serious patients who have been waiting three hours and 50 minutes 

Royal College of Emergency Medicine president elect Adrian Boyle told HSJ this type of patient flow could be ‘diverting clinicians away from more sick cases to people with lower acuity’, adding ‘the scrutiny and managerial grip that used to go with [the target]’ has been ‘taken away’.

The four-hour target outlines that at least 95 per cent of patients attending A&E should be admitted, transferred or discharged within four hours.

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