Monday, 17 February 2020

38 Degrees Campaign Reply – A&E 4 hour waiting times

Thanks to those constituents who have contacted me regarding proposals to change the four-hour standard in A&E departments, particularly those who have shared their personal experiences with A&E waiting times.

There are undoubted pressures facing the NHS, and in particular A&E services, and the need to find new and innovative ways to deliver better health outcomes in a timely manner is a priority. The government is reviewing current measures, such as the four-hour standard in A&E, to explore ways to improve patient care, patient outcomes and effectively measure where this is working and where it is not.

The four-hour standard target since its introduction has focused resources into emergency care with the number of emergency doctors growing by almost 50% since 2009 and significant increases in the numbers of nurses working in A&E. This is positive progress and any new proposals would be designed to help maintain this.

The proposals referred to by this campaign are not intended to ‘scrap’ the four-hour waiting times, but to review and update them in line with the major changes in the practice of medicine and way that urgent and emergency care services are delivered since its inception in 2004, more than 15 years ago.

The four-hour standard only measures and reports performance of one aspect of the urgent and emergency care system and the clinically-led review of NHS access standards states a more sensitive method of measuring the timeliness of care is needed. This review raises the following concerns with the current standard:

·       The target does not measure total waiting times
·       The target does not take into account patient condition
·       The target does not measure whole system performance
·       The target does not consider clinical advances in Same Day Emergency Care
·       The target is not well understood by the public

Proposals are therefore aiming to bring more transparency to waiting times, additional focus on time spent by patients awaiting admission, introduce new timescales for critically ill patients needing immediate care (e.g. patients experiencing a stroke or sepsis), ensure clinical-decision making takes places at a clinically appropriate time and be more meaningful in reflecting the true picture in A&E departments and hospitals a whole.

However, it is important to note that at this stage these are proposals and no plans are in place to implement any of the above without comprehensive consultation with clinical experts, appropriate charities and wider stakeholders. There are a number of hospital trusts testing the initial proposals and the views of staff, patients and local stakeholders operating under these proposals will also be captured as part of this evaluation.

The NHS is one of the best and most loved institutions we have and this government is delivering on the NHS. We have seen funding increases every year I have been MP as well as millions of pounds of investment in Cornwall, including the recent £450m to improve hospital facilities in the Duchy. I am confident this government will continue to ensure the NHS is priority and any new measures are appropriate, transparent and focused on providing quality patient outcomes in a timely manner. I will follow this review with interest, and work with colleagues in the Department of Health and Social Care and wider colleagues in Westminster to ensure the needs of the NHS and in particular the unique challenges we face in Cornwall are fully considered.