The Royal College of Physicians of Edinburgh has today [11 January 2017] called on the Secretary of State for Health, Jeremy Hunt, to maintain the four-hour target for patients accessing emergency care. The Secretary of State for Health made a statement to Parliament on 9 January 2017 which suggested that the current four hour target for all patients to access emergency care should be reconsidered.

Mr Hunt said given the pressures on Accident and Emergency Departments that it should be a ‘promise to sort out all urgent health problems within 4 hours, but not all health problems however minor’.

The current four hour standards across the UK were introduced due to patient pressure, and supported by Royal Colleges. The access to emergency treatment target is an important measure of the whole system response to care, covering the entire patient journey when they are in need of urgent healthcare.

The risks of not measuring all patients who go through Emergency Departments could result in an increase in overcrowding, an increase in the variability of treatment for different groups of patients and increase in the workloads of staff, all of which will lead to poorer patient care.

Prof Derek Bell, President of the Royal College of Physicians of Edinburgh, said:

“The comments by the Secretary of State for Health suggesting a potential change to how emergency access is measured are not supported by published evidence. “Not measuring those patients ‘perceived to have less significant illness’ will not remove them from the system. There is the potential to create different classes of patient and make it harder for those who may have difficulty making their voices heard – for example, the elderly, the vulnerable and those with mental health problems. It may also lead to overcrowding and increase the workloads of staff at night when staffing levels are lower, with the risk of compromising care. “In Scotland emergency departments have consistently performed better than other parts of the UK over the last 18 months. While they are also experiencing the same winter pressures, including recent difficulties meeting the four hour target, they will recover from these more quickly. This is in part due to the re-introduction of the National Programme, ‘Six Essential Actions to Improving Unscheduled Care’. “Changing the way the problem is measured will not fix it – but a National Programme could.”

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Contact: s.collier@rcpe.ac.uk 0131 2473658

Notes to Editors:

1. The 6 Essential Actions to Improving Unscheduled Care can be found here

2. A recent report by the House of Commons Health Committee on Winter pressures in accident and emergency departments (published October 2016) found support for the four hour target and recommended retaining the standard. (Chapter 5)