Government proposes ‘clinical exceptions’ to A&E targets
pharmafile | October 28, 2003 | News story | |Â Â Â
The Government is to modify one of its key waiting times targets after sustained protests about its inability to reflect the needs of all patients.
The centrally imposed target that no patient should wait more than four hours in A&E has been given a level three priority the highest possible, with the Prime Minister personally involved in ensuring in its delivery.
Acute trusts have invested heavily in meeting the targets which play a leading role in determining their star rating, and 90% of all A&E patients are now treated within four hours.
But health professionals have continued to protest that the target fails to take into account the diversity of patients in A&E and the complex reasons behind waits.
Health Secretary John Reid has now responded by proposing 'clinical exceptions' to the four-hour rule.
"In cutting the time spent in A&E our goal has always been to improve the quality of care to patients. Doctors have told us that there are certain exceptional cases where it is better for the patient to remain in A&E fir longer than the four-hour target. Targets are a means to an end. They are about putting patients first. If the target gets in the way of clinical requirements then it must be refined."
The proposed exceptions include:
– Patients in the resuscitation room undergoing active resuscitation, whose clinical condition would be jeopardised by the transfer to another area
– Patients who unexpectedly deteriorate and need the continued care of A&E specialists.
The Health Secretary added: "Targets are continuing to drive up performance, but I want to be sure that we are listening to staff and giving them the flexibility to ensure that high clinical standards are maintained."
The concession could give new hope to health professionals in other parts of the NHS that their targets will be reviewed.
PCTs were all recently star-rated on a number of public health targets – such as success in reducing teenage pregnancies many of which fail to take into account huge regional variations in public health problems.
