Four-hour A&E target to be replaced

The NHS is planning to ditch the four-hour A&E waiting times target and replace it with a raft of new measures.

Instead of being seen within four hours, those patients in England with the most serious conditions such as heart attacks, strokes and sepsis will receive rapid treatment, while people with more minor conditions can expect to wait longer.

The NHS, which is piloting the plans, will in future set a target for treatment of the most urgent cases.

The existing four-hour target has not been met since July 2015 and some experts say it is unlikely the NHS could ever hit it again.

Figures for January showed that A&E waiting times in England reached their worst level since records began.

Just 84.4% of patients were treated or admitted in four hours, against a 95% target, meaning nearly 330,000 patients waited longer than they should.

The data also showed that 83,519 people in January endured very long waits – often called trolley waits – to be admitted to hospital.

This data will not be published in the future but is likely be rolled into a measure of the average time people spend in A&E.

Under the plans, patients will receive an assessment by a medical professional when they walk through the door of A&E, and cases will then be prioritised according to the level of urgency.

NHS England has long said that the current four-hour A&E target is outdated, with data suggesting hospitals are being driven to hit the target.

Around a fifth of all emergency admissions from A&E happen in the final 10 minutes before the four-hour deadline.

On cancer, as previously announced, a new measure will mean that people with suspected cancer will receive a definitive diagnosis within 28 days of urgent referral by their GP or a screening service.

A&E targets
Targets for cancer care waiting times were also revealed (Lynne Cameron/PA)

But this means the two-week wait to see a cancer specialist will be scrapped and replaced with the 28-days-to-diagnosis target.

Four other 31-day cancer targets, which mark the time from diagnosis to first treatment for all cancers, will also be replaced by a single 31-day target.

This is 31 days from decision to treat to a person to them receiving their first treatment.

Patients must also start their first treatment for cancer within 62 days following an urgent GP referral for suspected cancer.

The current 18-week target for people to start treatment could also be replaced by one measuring the average time taken to start treatment.

People who arrive at A&E experiencing a mental health crisis will also receive emergency care within one hour.

Professor Stephen Powis, the NHS in England’s national medical director and leader of the review of targets, said: “The NHS is aiming to improve care for patients and save hundreds of thousands more lives over the coming years, with greater access to mental health support, better treatment for the major killer conditions and services which are more joined-up, personalised and closer to home.

“So, as we build an NHS that is fit for the future, now is the right time to look again at the old targets which have such a big influence on how care is delivered, to make sure that they take account of the latest treatments and techniques, and support, not hinder, staff to deliver the kind of responsive, high-quality services that people want to see.”

Professor Ted Baker, chief inspector of hospitals for the Care Quality Commission, said: “Emergency departments need a set of standards which gives priority to patients with life-threatening conditions, ensures people get care in a timely way, and puts pressure on the whole hospital to end long corridor waits for those who need admitting.”

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