Patient safety

Providers and BMA hit back at Hunt’s demand to meet A&E target by 2018

Doctors and providers have responded to health secretary Jeremy Hunt’s call for hospitals to get back on track with A&E targets by next year, saying that waiting times in emergency departments cannot be shortened without new funding for the NHS.

In a speech on Thursday, Hunt sent a message to NHS trusts that improvements had to be made in meeting the national target of seeing 95% of patients within four hours of them being admitted into A&E departments.

This aim has been missed in England since July 2015, and fell to a record low of 85.1% in January this year. But achieving it is “absolutely critical” to patient safety, the health secretary argued.

Hunt’s calls come exactly two months after he suggested scrapping the four-hour target for non-urgent cases, an idea thoroughly slammed by A&E doctors and dismissed as misguided.

Coinciding with his speech, leaders from NHS England and NHS Improvement have written to hospital CEOs demanding that they get back on track with the target by March 2018.

The BMA has now hit back at the demands by asking for clarification from the government as to how exactly improvements can be made without additional funding.

Its council chair, Dr Mark Porter, said: “It’s very easy to call for A&E to get back on track by next year, but the government needs to explain just how this will happen considering that yesterday’s Budget didn’t come close to addressing the black hole in NHS finances.

“It would be naïve to think that the crisis in the NHS stops solely at the hospital door when, in fact, our A&E departments are struggling because of an overstretched system. The NHS isn’t at breaking point because of front-line financial mismanagement, or individual chief executives’ poor decision making, but because of the conscious, and constant, underinvestment in our health service.”

Chris Hopson, NHS Providers CEO, agreed with the BMA’s arguments, noting that performance against the target has “declined rapidly” over the last few years and can only be helped by “very significant extra investment” in 2017-18.

“We can't, at this point, see where that money will come from,” he added. “While the extra £100m to support A&E performance improvement announced in the Budget is welcome, it's a fraction of what is needed to preserve the existing level of performance, let alone dramatically improve performance to hit the 95% target.

“Given how far we are currently behind the target and how much lower NHS funding increases will be in 2017-18 we think it is unrealistic to expect trusts as a whole to meet the 95% A&E target within a year.”

The organisations’ responses follow the Budget announcement earlier this week, which pledged £1bn to adult social care in the next year but very little in the way of fresh funding for struggling health services.

After the Budget was announced, the BMA described its disappointment at the lack of funds for the NHS, arguing that the budget did “nothing to address the gaping hole in NHS finance”.

The government had argued that supporting social care would have the knock-on effect of also easing pressure on NHS services. However, this argument was disputed by IHM, which warned of “Armageddon” for the health service should the government continue with critical underspending.

Dr Porter has once again presented this argument to the government, saying: “To really help doctors deliver the best care for patients, the government needs to look at the long-term funding, capacity and recruitment issues facing the system as a whole if we are to get to grips with the pressures the NHS faces year in, year out, but which are compounded during the winter months.”

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