Hospitals use ploys to beat 4 hour deadline on A&E waiting times targets
Patients are being admitted to hospital to avoid breaching a labour Government target on waiting times, NHS figures suggest.
More than one in twenty patients attending hospital in an emergency are being admitted to wards just minutes before the maximum four hour wait.
Health unions have complained that staff are being “pressured” into manipulating data and admitting patients unnecessarily to meet the target, which aims to treat or discharge all accident and emergency (A&E;) patients within four hours.
Figures from the NHS Information Centre show that almost all patients in England are seen within the four hour deadline, but there is a peak in the number of people admitted to a ward with just ten minutes to spare. Two-thirds of those treated as the deadline approaches are admitted to hospital, compared to just over one in five patients coming from A&E; overall.
It is the first time such analysis has been done and the statistics are categorised as “experimental”.
The Royal College of Nursing warned that the four hour target meant some nurses were “pushed into practices” that were risky for patients.
It said that there were “negative consequences” for patient care, especially those needing treatment in A&E; wards, but not necessarily requiring an overnight stay.
A survey of its members found that nine out of ten accident and emergency nurses claimed they had been unduly pressured to meet the four hour target.
Mark Porter, chairman of the British Medical Association’s consultants’ committee, said that the admission rates were worrying.
“This suggests that when patients have been waiting close to four hours, there is a rush to discharge or admit them so that the hospital meets the four-hour target,” he said.
“Patients must always be treated on the basis of their clinical need, not simply because they have been waiting close to four hours.”
Katherine Murphy, director of the Patients Association, agreed that the right patients are not always made a priority under the target.
“This results in doctors making rushed decisions at three hours and 50 minutes, with patients having to be admitted inappropriately at huge cost to the NHS,” she said. “We have heard instances of ambulance drivers being forced to wait outside A&E; with seriously ill patients, until staff have cleared a backlog of people who need to be seen within the four hour target.
“It is unfair to make NHS staff feel like they have to put meeting this target ahead of what’s in the best interests of patients.”