Four Hour Emergency Target
- Four Hour Emergency Target
The Four Hour Emergency Target was introduced by the Department of Health for National Health Service acute hospitals in England. Setting a target that, by 2004, at least 98% of patients attending an A&E department must be seen, treated, admitted or discharged in under four hours.
Objective
The UK Labour government had identified a requirement to promote improvements in A&E departments, which had suffered underfunding for a number of years. The target, accompanied by extra financial support, was a key plank to achieve the improvements.
Results
Tony Blair felt the targets had been successful in achieving their aim. "We feel, and maybe we are wrong, that one way we've managed to do that promote improvements in A&E is by setting a clear target"[ [http://news.bbc.co.uk/1/hi/health/4339653.stm BBC NEWS | Health | Target 'putting A&E care at risk' ] ] .]Forty-eight per cent of departments said they did not meet the target for the period ending 31 December 2004 [ [http://www.bma.org.uk/ap.nsf/Content/AandEwaiting BMA - BMA survey of accident and emergency waiting times, March 2005 ] ] . Government figures show that in 2005-06, 98.2% of patients were seen, diagnosed and treated within four hours of their arrival at A&E, the first full financial year in which this has happened [ [http://news.bbc.co.uk/1/hi/health/6267897.stm BBC NEWS | Health | A&E success 'not sustainable' ] ] .]Missing the target
According to the BMA
*Not enough inpatient beds
*Delayed discharges
*Delay in accessing specialist opinion
*Not enough nurses
*Not enough middle grade doctors
*Department too small
*Delay in accessing [diagnostic services]
Exceptions
The original target was set at 100%, but lowered to reflect clinical concerns that there will always be patients who need to spend slightly longer in A&E, under observation [ [http://www.oxford.gov.uk/files/meetingdocs/27833/item%207.pdf The Four Hour Target in Accident and Emergency ] ] .
Pressure
Even though exceptions are allowed to the targets, concerns have been raised that the target has put pressure on A&E staff to compromise patient care.3 A significant proportion (90%) of A&E consultants welcomed the 4 hour target in a staudy but felt that 98% was too high a target
References
Wikimedia Foundation.
2010.
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