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Nurse directors stick to ‘scrapped’ targets

  • 2 Comments

Nursing directors have said they plan to maintain performance against high profile waiting time targets, despite the new government’s decision to scrap or revise them.

In June the government changed the accident and emergency target so trusts have to see 95 per cent of patients rather than 98 per cent within four hours. It also scrapped the target for 90 per cent of elective inpatients to be treated within 18 weeks of referral.

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However, nursing directors contacted by Nursing Times say they intend to maintain performance against the old standards.

Sheffield Teaching Hospitals Foundation Trust director of nursing Hilary Chapman said the targets were part of quality care, and were also required by the hospital’s local primary care trust.

She said: “We are continuing to aim for 98 per cent. Firstly, this maintains a focus on good patient flow through the department and timely treatment and secondly, it remains part of our contract with our commissioners locally.

“Our position on [the elective target] is similar - it’s about the principle behind it and patients accessing care and treatment in a timely manner, which nurses embrace as part of good care and experience.”

University Hospitals Birmingham Foundation Trust director of nursing Kay Fawcett, a former emergency care nurse, said her trust was also continuing to monitor and maintain performance against both standards.

She said: “We are definitely sticking to them - they are both things that help us with quality.”

The 2 per cent of A&E patients who did not have to been seen within four hours gave enough flexibility and 18 weeks was “quite long enough” to wait for elective treatment, she said.

“Not having a national target is not a bad thing as such, but we want to have a process by which we get people assessed much more quickly,” she said.

In June, Royal College of Nursing general secretary Peter Carter welcomed the changes to the A&E target, saying it had led to nurses being “put under tremendous pressure - in some cases to the detriment of patient care - to meet the 98 per cent target”.

  • 2 Comments

Readers' comments (2)

  • In my 30 month exposure to working in the ED I have come to the conclusion that the 4 hour target looked good on paper but raised questions.
    What does meeting the one size fits all national target of 95%/98% of patients attending the ED being discharged from the department to either home or to a ward in the hospital actually show? It certainly does not demonstrate quality of care, particularly when patients are transferred to wards without treatment being started because they have been in the department 239 minutes.
    There have to be valid, evidence based measures of quality, e.g. a timely assessment or timely administration of analgesia/antibiotics; a thorough medical examination and management plan.

    The impact of this change will require a systematic review of the management of emergency admissions throughout an hospital.
    At the moment the management is fragmented and driven by the four hour target, the queues in the ED are not present, but patients are still waiting on admission wards.
    Someone is going to have to bite the bullet and do this work, it's not an easy task, instead of just tweaking the system at its peripherary. It is a large systems engineering exercise that needs to be done efficiently and completely. It may need a lot of investment of time and money if long waiting times in the ED are to be avoided, but if done properly then any future adjustments should be able to be implemented relatively quickly and cheaply.

    Unsuitable or offensive? Report this comment

  • In my 30 month exposure to working in the ED I have come to the conclusion that the 4 hour target looked good on paper but raised questions.
    What does meeting the one size fits all national target of 95%/98% of patients attending the ED being discharged from the department to either home or to a ward in the hospital actually show? It certainly does not demonstrate quality of care, particularly when patients are transferred to wards without treatment being started because they have been in the department 239 minutes.
    There have to be valid, evidence based measures of quality, e.g. a timely assessment or timely administration of analgesia/antibiotics; a thorough medical examination and management plan.

    The impact of this change will require a systematic review of the management of emergency admissions throughout an hospital.
    At the moment the management is fragmented and driven by the four hour target, the queues in the ED are not present, but patients are still waiting on admission wards.
    Someone is going to have to bite the bullet and do this work, it's not an easy task, instead of just tweaking the system at its peripherary. It is a large systems engineering exercise that needs to be done efficiently and completely. It may need a lot of investment of time and money if long waiting times in the ED are to be avoided, but if done properly then any future adjustments should be able to be implemented relatively quickly and cheaply.

    Unsuitable or offensive? Report this comment

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