Hospital time targets fail to alter procedures

A team at Sheffield University examined 735,000 visits to 15 casualty units from 2003 to 2006.

They found the total length of patient stay actually increased although the numbers leaving A&E within four hours increased from 84 per cent to 96 per cent over the period. Younger patients benefited more than the elderly who were more likely to need transfer to a hospital bed.

Professor Suzanne Mason, who led the work, said: “We hoped that the target would have led to improved processes leading to shorter wait times in the emergency department without diminishing time for physician-patient interactions. But we did not observe this pattern.

“Our results suggest that an absolute cut-off may not be the best way to manage emergency department crowding. However there was a marked improvement in the proportion of patients being seen and leaving within four hours in the emergency departments we looked at.”

The target was introduced by Labour to cut waiting times. It has been abolished by the coalition and replaced with quality measures which only a minority of casualty units have met. Waiting times have since risen and some patients requiring admission to beds have faced particular delays.