Nine out of ten A&E nurses have felt unduly pressurised at some point to meet the four-hour waiting target, according to an RCN survey unveiled at congress.
Moreover, 78% of the 500 respondents to the survey believed that the introduction of the target had led to the care of patients with complex or multiple needs being rushed and compromised.
Despite half of the respondents claiming the target had made a positive impact on patient care, 75% said patients were regularly admitted to inappropriate wards in order to meet the target.
RCN general secretary Peter Carter said: ‘The RCN is calling for a more realistic target of 95% of patients seen within four hours rather than the current 98%. This would give A&E staff the flexibility and the breathing space to deliver the personalised care the government are demanding.’
The four-hour target was also the subject of a congress debate entitled ‘stop-watch care’, which was proposed by the RCN Lothian branch. It discussed the impact on patient care and staff morale.
Lisa Falconer, who led the discussion, said such targets should be decided by clinicians rather than politicians.
Rabina Tindale, chairperson of the RCN Emergency Care Association, said: ‘I feel that we’re nursing a target rather than patients. Emergency nurses don’t want patients to wait more than four hours. What we want is for patients to receive the best and most appropriate care.’
The four-hour target had placed huge pressure on the whole NHS system, not just emergency care, warned Heather Jarman, a member of the association’s steering committee.
Speaking to NT at congress, Healthcare Commission chief executive Anna Walker agreed that A&E targets could have wider negative consequences.
‘I am not saying that the A&E target is bad – it does a lot for patients,’ she said.
‘But we do have to look at the consequences of it and ensure adverse consequences are identified and we deal with them. If patients are moved out quickly they may be moved into wards that are less appropriate for their needs,’ she added.
The target was introduced into the NHS in England in 2002 but trusts had until December 2004 to begin meeting it.