Poor quality data on the work of nurses and other accident and emergency clinicians has led the government to change the way it measures performance in accident and emergency.
The government has retreated from plans to fully implement a set of eight performance indicators, which measure for time to initial assessment and time to treatment by a decision-making clinician - two tasks often undertaken by nurses. The indicators replaced the four hour A&E standard in April.
Trusts were originally expected to be meeting the minimum threshold for five of the eight new indicators, which were developed with advice from the Royal College of Nursing, by 1 July.
However, due to concerns about the quality of data on the new indicators, trusts will for the time being have to meet only two - one on timeliness and one on patient impact, and will have to continue meeting the four hour A&E standard.
National clinical director for urgent and emergency care, Professor Matthew Cooke, said this was because the Department of Health knew the data on the four hour standard “worked”.
He told Nursing Times data on time to initial assessment, the most nurse-led indicator, which requires all patients arriving by ambulance to be given a full assessment including a pain score and a physiology assessment within 20 minutes had been particularly unreliable, making it “impossible to tell how trusts are doing”.
Royal College of Nursing adviser on acute and emergency care Alan Dobson said trusts had been “struggling” with the new indicators but he welcomed their focus on quality and safety.
“The indicators are trying to make sure the right thing is done at the right time, with the right people assessing people adequately, not waiting until four hours 55 minutes then worrying about the target,” he added.