Forty per cent of nurses believe their colleagues are involved in helping to meet waiting time targets by underhand means, often referred to as ‘gaming’.
And one in 10 hospital nurses say they have personally been asked to engage in gaming to help meet waiting times this autumn.
The figures are revealed as part of Nursing Times’ investigation into pressures on the front line, which included an online survey of around 600 acute sector nurses.
There have been long-standing concerns about trusts fiddling the system to meet the Department of Health’s “operational standard” that 98 per cent of patients should spend four hours or less from arrival at A&E to admission, transfer or discharge.
Nottingham University Hospitals Trust was forced to apologise last month after admitting it had altered figures to meet the target.
Doctoring of figures, with incorrect discharge times being recorded for patients nearing the deadline or altered later, was one of the most common examples of gaming cited in the survey.
One said: “I have witnessed other colleagues altering times of patient leaving A&E department, so they do not breach, but I will not take part in this myself.”
Other examples include patients being temporarily moved from A&E – for example, to observation areas, corridors and in one case the theatre recovery ward – and patients being unnecessarily admitted to mixed-sex bays or sent to specialist wards without being seen by a doctor first.
One respondent said part of their A&E department had been re-badged as the “clinical decision unit” and was no longer deemed part of A&E.
The Nursing and Midwifery Council warned that nurses would be in breach of the code of conduct if patient safety was put at risk as a result of gaming. NMC chief executive and registrar Dickon Weir-Hughes told Nursing Times: “Nurses and midwives should never be pressured into acting in a way that could cause them to breach their code.”
He said those concerned that gaming was taking place should inform their senior manager or nurse director, and warned: “Senior nurses could be putting their registration at risk if they fail to make the care of people their first concern,” Mr Weir-Hughes said.