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Last Updated: Monday, 2 June, 2003, 23:53 GMT 00:53 UK
A&E target survey rubbished
The audit happens next week
The audit happens next week
Doctors say many accident and emergency departments do not have the resources to meet government waiting time targets - despite upbeat results from an official audit.

They say many units were only able to meet the target by putting in place measures that did nothing to help patients get proper care.

The government wants 90% of patients entering A&E units to be admitted, transferred or discharged within four hours.

The 90% target can be reached, but only when the appropriate resources are available
Mr Donald MacKechnie
The official audit, carried out in late March, showed 85% of the 207 A&E departments in England met this target during the week in which statistics were collected.

But a follow-up study by the British Medical Association has found that in the following week the figure dropped to 63%.

A third of the doctors surveyed did not believe the figures the government published for their department were accurate.

Nearly three-quarters (72%) said their trusts had gone to extraordinary lengths to meet the target, often by cancelling routine operations, spending money on agency staff, and making doctors and nurses work double shifts.

Most did not believe the resources provided were sustainable.

The majority of respondents felt these measures had distorted clinical priorities in their trust - many said waiting times for patients with the most serious conditions had increased.

Part of the problem was that many hospitals were having to deal with an increased number of patients with minor conditions, who reported to A&E rather than going to their GP.

The survey also revealed concerns that during the monitoring period patients were being:

  • rushed through A&E
  • moved before being adequately assessed or stabilised
  • inappropriately admitted
  • transferred to the wrong department

Mr Donald MacKechnie, an A&E consultant in Rochdale and chairman of the BMA's A&E Committee, said "Our survey shows that the 90% target can be reached, but only when the appropriate resources are available.

"Many of the doctors we surveyed were proud of the level of service they provided in the week of monitoring, but it was clearly dependent on staffing levels that weren't there the next week."

Government response

A Department of Health spokeswoman said in the long term, reducing waiting times in A&E would be met through a combination of sustained investment and changes in the way the NHS works.

She said: "We are not putting pressure on hospitals to set clinical priorities aside - exactly the reverse.

"Manipulation of statistics or treatment of patients in an inappropriate way is not acceptable.

"Reducing waiting times in A&E is a priority for the government because NHS staff, patients and the public have told us it is a priority for them.

"Without the March milestone and next year's final target, the service would not have made the progress it has as quickly as it has.

"They help to concentrate minds and focus resources, and to hold people to account, from local management to ministers."


Shadow Health Secretary Dr Liam Fox said noone was fooled by "doctored" figures issued by minsters about the NHS.

He said: "In their pathological obsession to meet targets there is no truth they will not twist.

"Neither patients nor medical staff are free from the political interference that is now strangling the health service."

Dr Evan Harris, for the Liberal Democrats, said: "Government target-setting is a sham which distorts resource allocation and takes money away from more needy areas.

"It reduces faith in statistics and destroys what remains of the government's credibility.

"Most importantly, government targets distort clinical priorities. The most urgent cases are not at the head of the queue.

"The government¿s priority should be to treat the sickest quickest."

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