NHS reforms

10.01.17

Hunt suggests scrapping four-hour A&E target for ‘non-urgent’ patients

The health secretary has sparked controversy by saying that the four-hour target for patient treatment shouldn’t apply to people who present to A&E with minor illnesses in a bid to ease pressure on ailing emergency departments.

Jeremy Hunt made the comments in an emergency statement in the House of Commons yesterday as A&E departments flounder over the winter period, with a third of England’s hospital trusts warning that high patient numbers were affecting care and stories of patients being increasingly diverted to other hospitals due to a lack of capacity.

In his emergency statement, Hunt also expanded upon prime minister Theresa May’s announcement earlier in the day of government action on mental health, including an Ofsted-style rating system of CCGs where mental health provision is inadequate.

“This government is committed to maintaining and delivering [A&Es’] vital four-hour commitment to patients,” Hunt said. “But since it was announced in 2000 there are nearly nine million more visits to our A&Es, up to 30% of whom NHS England estimate do not need to be there,” Hunt told the House during his statement.

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

Hunt explained that NHS England and NHS Improvement will continue to look to provide patients who do not need to be in A&E with quality alternative options, with critics blaming poor GP and social care services for the rise in emergency department attendance.

The four-hour target, revised in 2010, currently obliges hospitals in England to examine and either admit, transfer or discharge 95% of A&E patients. However, hospitals have been consistently struggling to hit that target.

The shadow health secretary Jonathan Ashworth rallied against Hunt’s comments, saying: “Is he really telling patients that rather than trying to hit that four-hour target, the government are now in fact rewriting and downgrading it?”

Hunt stressed that he was actually recommitting the government to the target, saying that the government is looking to control demand of patients who do not need to attend A&E through an increased investment in general practice.

“If we have the situation NHS England now describes, where up to 30% of the people in A&E departments do not actually need to be there, we risk not being able to deliver that promise for the people who really do need it,” Hunt said.

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