Government steps towards new A&E targets

Ministers have given the green light for NHS England and Improvement to consult before December on a proposed new basket of metrics to replace the four-hour accident and emergency target.

The Department of Health and Social Care announced the move, a significant step towards ditching the target, while confirming another batch of winter capital funding allocations, and confirming a national “111 first” model.

The announcement does however mean the process of replacing the four-hour target with new A&E standards will move slower than NHSE/I had outlined this summer. It said in July it wanted the new A&E standards in place before winter, a plan also backed by the Royal College of Emergency Medicine as revealed by HSJ.

These moves come amid mounting concern that people unable to get COVID-19 tests are heading to emergency departments; and that some emergency departments are now becoming busy with growing non-covid demand. 

The proposals for the consultation have not yet been finalised. HSJ understands they will consist of work largely drawn up by NHSE’s clinical review of standards group before March but put on hold when the COVID-19 outbreak hit the UK.

Likely choices for the metrics are: time to initial clinical assessment in A&E, time to emergency treatment for critically ill, mean waiting time, and a new 12-hour metric where the clock starts from when the patient arrives at the emergency department rather than at decision to admit as is currently the case.

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Source: HSJ, 17 September 2020