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NHSE pushing for four-hour target to be scrapped in April


System leaders are pushing for their new bundle of urgent and emergency standards to replace the four-hour target from April, HSJ has learned

Well-placed senior sources said the NHS is seeking to persuade the government that a new package of measures can be introduced from the start of 2022-23.

The new package of targets, which include ambulance response and handover times, as well as arrival to admission times, have some traction among ministers but have not yet got the green light from the top of government.

The new ‘bundle of ten standards’:


  • Response times for ambulances.
  • Reducing avoidable trips (conveyance rates) to emergency departments by 999 ambulances.
  • Proportion of contacts via NHS 111 that receive clinical input.


  • Percentage of ambulance handovers (from ambulance to A&E) within 15 minutes.
  • Time to initial assessment — percentage within 15 minutes.
  • Average (mean) time in department — for non-admitted patients.


  • Average (mean) time in department — for admitted patients.
  • Clinically ready to proceed (time from when decision is made to admit or discharge, and patient is admitted or discharged).

Whole system

  • Patients spending more than 12 hours in A&E.
  • Critical time standards — aimed at ensuring the highest priority patients get care within a set timeframe such as an hour.

Read full story (paywalled)

Source: HSJ, 18 November 2021

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