Royal College of Physicians of Edinburgh defends four-hour A&E targets

A&E - credit Lydia

Targets which require accident and emergency departments across the UK to treat patients within four hours should be maintained, the Royal College of Physicians of Edinburgh (RCPE) has warned.

A 4 hour target of 98 per cent of visits was adopted by the Scottish Government after it was shown to have an impact in England but was later reduced to 95 per cent as emergency departments struggled to cope. 

UK Health Secretary Jeremy Hunt cast doubt on its future south of the border this week when he told MPs the target may need to be revised. 

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"If we are going to protect our four-hour standard, we need to be clear it is a promise to sort out all urgent health problems within four hours - but not all health problems, however minor," he said.

However RCPE defended the existing arrangements, describing them as "an important measure of the whole system response to care", warning watered down targets could lead to more overcrowding in hospitals. 

RCPE president Professor Derek Bell said Hunts comments were not supported by evidence. 

“Not measuring those patients ‘perceived to have less significant illness’ will not remove them from the system," he said.

"There is the potential to create different classes of patient and make it harder for those who may have difficulty making their voices heard – for example, the elderly, the vulnerable and those with mental health problems. It may also lead to overcrowding and increase the workloads of staff at night when staffing levels are lower, with the risk of compromising care."

Bell also praised a Scottish Government initiative aimed at improving patient journeys through unscheduled care, suggesting NHS England could adopt something similar.

“In Scotland emergency departments have consistently performed better than other parts of the UK over the last 18 months. While they are also experiencing the same winter pressures, including recent difficulties meeting the four hour target, they will recover from these more quickly. This is in part due to the re-introduction of the National Programme, ‘Six Essential Actions to Improving Unscheduled Care’."