Knowledge (XXG)

NHS targets

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the time they are admitted to a ward. Measured in this way February and March 2022 show around one in five admissions through ED waited more than 12 hours from arriving until being admitted to a ward – equating to around 158,000 cases, 22% of attendances. Problems were particularly severe for people with mental health problems, with many examples of mental health patients waiting up to three days in emergency departments for a mental health inpatient bed to become available. When time was measured from time of arrival in the department to admission to a ward the figures of people waiting more than 12 hours were about six times greater than the nationally published figures which in July reached 29,317.
442:, tracked 41 million visits to A&E departments in England in order to better understand the pressures leading to increased waiting times and breaches of the four-hour target. Researchers identified a rise in older patients and related increase in long-term conditions as key factors, alongside extremes of temperature (in both summer and winter) and crowding at peak times. They noted that the majority of pressure was falling on major A&E units, and proposed that rising demand as a result of ageing and population growth may be pushing already stretched emergency departments beyond maximum capacity. 63:
ambulances have been forced to queue up outside a busy emergency departments so that the ambulances might not be able to meet their target in responding to emergency calls, but the hospital can meet its A&E target. Excess emphasis on the targets can mean that other important aspects of care, especially those not easily measured, may be neglected. Some have however praised targets for producing faster reductions in waiting times in England than other UK countries between 1996 and 2006.
170: 318: 573:. 2,432 patients had waited longer than a year in November 2018. In January 2019 NHS England announced that in future both providers and commissioners would be fined ÂŁ2,500 for each such patient. In February 2022 299,478 patients had been on the list for over 52 weeks. Of those 23,281 had been waiting more than 2 years. 529:
not to do so, or they choose to wait. The proportion of people waiting more than the six week target for diagnostic tests was at its highest since records began in September 2018. By August 2019 less than 49% of hospital services were achieving the target and across England the average wait was around 23 weeks. The
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patients waiting more than 12 hours. The Welsh NHS Confederation responded to the figure by stating its disappointment but acknowledging numbers of patients attending with complex needs were increasing in Wales. Ambulance response times however improved and hit their target for the first time since October.
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Nuffield Trust have identified Welsh underperformance as influenced by the Welsh population being older, sicker and having more deprivation than any other UK nation. Performance against the target has like all other UK nations in recent years, having declined by 7.5% between May 2018 and September 2019.
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Between January and March 2018 25,475 operations were cancelled at the last minute for non-clinical reasons by NHS providers - 20% more than the first quarter of 2017, and the highest number since records began in 1994–95. This was 1.3% of all elective activity - the highest proportion recorded since
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In December 2019 there were 2,347 breaches, compared with 284 recorded in December 2018. In February 2022 there were 16,404 breaches and in March 2022 22,506. The NHS Standard Contract for 2022-23 requires hospitals to count 12-hour waits from time of patients’ arrival in the Emergency Department to
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must be seen, treated, and admitted or discharged in under four hours. The target was further moved to 95% of patients within four hours in 2010 as a result of the coalition's claims that 98% was not clinically justified. Trusts which failed to meet the target could be fined. In July 2016 NHS trusts
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from April 2022. Performance is to be measured on the percentage of services delivered within two hours. Mental health targets are also planned, although no start date has been set, requiring require that urgent referrals to community crisis services should be seen within 24 hours, and “very urgent”
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proposed a two-hour standard for urgent community response services in England. These include prescribing and reviewing medication, access to physiotherapy and occupational therapy, and help with nutrition and hydration. Data has been collected since July 2020 and was first published in June 2022.
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together with other medical groups fear patients are waiting longer in anxiety and pain for hospital procedures. The target was that 90% of patients admitted to hospital for treatment and 95% of those not admitted should receive consultant-led care within 18 weeks unless it is clinically appropriate
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In England, the target is also for 95% of A&E patients to be treated, transferred, and discharged within four hours. However performance has fluctuated between 90 and 84% between 2015 and 2019, consistently putting it second in the United Kingdom. However performance against the target declined
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to be astonishing. Attendance at A&E departments has been increasingly steadily for many years, more so at ‘type 3’ departments, like urgent care centres (where waiting times are generally lower). In the first eight months of 2018, an average of 67,000 people attended each day. In January 2019,
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By December 2014, the number of patients being treated within four hours had fallen to 91.8%. From December 2015, the 95% target over England as a whole was missed every month. From October–December 2016, only 4 out of 139 hospitals with major type 1 A&E departments met the target. In November
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cycle. It is claimed that though A&E targets have resulted in significant improvements in completion times, the current target would not have been possible without some form of patient re-designation or re-labelling taking place, so true improvements are somewhat less than headline figures might
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led to more than 1,000 cases of patients waiting over 12 hours for admission in 2018–19. This was about a third of all the 12 hour breaches, which were mostly mental health cases - where admission to a ward is not within the control of the trust running the A&E department. A review found that
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At the same time as the four target was introduced a target that no patient should wait longer than 12 hours before they are admitted to a ward, if that is required, was introduced. In England time was measured from the point a decision to admit is made and not from the moment the patient arrives.
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In Scotland, the target is for 95% of A&E patients to be either admitted, transferred or discharged in four hours. It was last met in July 2017. Scotland has performed best on this measure out of the four UK nations, a position it has held since September 2015. However like all other UK nations
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In Wales, the target is also for 95% of A&E patients to be treated, transferred, and discharged within four hours. While higher than the performance in Northern Ireland (60%), the Welsh NHS is third in the United Kingdom, putting it 7 percent behind NHS England and 8% behind NHS Scotland. The
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In March 2022 average waits for an ambulance for stroke and heart attack patients (category 2) reached as long as two hours in some regions. The national target for reaching them is 18 minutes. According to the Association of Ambulance Chief Executives more than 3,000 patients may have suffered
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introduced far more targets and managed performance far more aggressively - a management regime sometimes referred to as 'targets and terror'. Targets were blamed for distorting clinical priorities, and in particular for one organisation achieving a target at the expense of another. For example,
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reported that performance on emergency admissions, trolley waits for more than four hours and A&E patients seen within four hours in the summer of 2017 was worse than in the winters of 2011–15. Performance against the four-hour wait target in the summer of 2018 was the worst second quarter
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The Welsh NHS sets a measure of patients waiting more than 12 hours to be treated, transferred, and discharged by A&E. In January 2019, the Welsh NHS has recorded a record 6,882 patients waiting more than 12 hours in A&E, and Morriston Hospital in Swansea represented 15% of all A&E
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performance recorded. Only 88.9% of patients were seen within four hours in September. The number of people admitted, transferred or discharged within four hours in emergency departments in September was up more than 3% compared to September 2017 with a 7% rise in emergency admissions said by
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Targets in Wales are set by the Welsh Government and set out in the NHS Wales Delivery Framework. The Welsh Government has taken a different approach to some areas of care, such as becoming the first nation in the UK to have a single waiting times target for cancer treatment. The Welsh NHS has
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In July 2021 it was reported that there was a 46% increase in patients waiting more than 104 weeks for treatment, from 2,597 to 3,802 from April to May. There were 5.45 million people waiting for hospital treatment in England in JUne 2021 with very large differences in the numbers waiting in
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announced that the target would in future only apply to "urgent health problems". In January 2018 only 77.1% of patients were admitted or discharged within four hours, the worst ever performance for type one A&E departments. In December 2018 it was reported that patients with only minor
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under the Conservative governments reduced the number of targets, in particular removing most of those relating to health inequality, and encouraged a system wide approach. However shortage of staff and funding meant that performance against targets nonetheless declined. Guidance published in
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Even though exceptions are allowed to the targets, concerns have been raised that the target has put pressure on A&E staff to compromise patient care. A significant proportion (90%) of A&E consultants welcomed the four hour target in a study but felt that 98% was too high a target.
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and top-down reorganisation of the NHS) hospitals in England struggled to stick to it, prompting suggestions that A&E departments may be reaching a limit in terms of what can be achieved within the available resources. The announcement of the reduction of the target from 98% to 95% was
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48% of departments said they did not meet the target for the period ending 31 December 2004. Government figures show that in 2005–06, 98.2% of patients were seen, diagnosed and treated within four hours of their arrival at A&E, the first full financial year in which this has happened.
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and are less demanding than in the rest of the UK. None have been met since 2015, and some for considerably longer. A&E waits when considered using the NHS measure of 4 hours to discharge show that performance in Northern Ireland has dropped 13% between May 2018 and September 2019.
366:“severe harm” from ambulance delays in February 2022. In June 2022 ambulance response times for the most serious category one incidents, including cardiac arrests, sank to an average of 9 minutes and 6 seconds, half a minute slower than in May. The target time is 7 minutes. 805:"Funding and performance of healthcare systems in the four countries of the UK before and after devolution: a longitudinal analysis of the four countries, 1996/97, 2002/03 and 2006/07, supplemented by cross-sectional regional analysis of England, 2006/07. Technical Report" 512:
In England 93% of patients referred for investigation of breast symptoms, even if cancer is not initially suspected, should be seen by a specialist within two weeks. Only 77.5% of patients referred for breast symptoms between April and June 2019 were seen within 2 weeks.
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Between January and March 2012 only 15 patients in England waited more than 12 hours, but in the same months in 2017 1,597 patients breached the target. In January 2018 1,043 patients waited over 12 hours for a bed, the worst figure ever recorded. 272 were at
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The effect of the target can be that patients waiting just below 4 hours get a lot of attention, but once the target is breached there is no further consequence. The average time spent by a patient in A&E who has breached four hours is around eight hours.
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famously put it - "hitting the target and missing the point". But they are alluring to politicians. Hunt says the effectiveness of targets is in inverse proportion to their quantity and points out that no other country runs its healthcare system by targets.
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In January 2022 research published in the Emergency Medicine Journal found that there was one extra death For every 82 admitted patients whose time to inpatient bed transfer is delayed more than 6 to 8 hours from time of arrival at the emergency department.
35:. These vary by country but assess the performance of each health service against measures such as 4 hour waiting times in Accident and Emergency departments, weeks to receive an appointment and/or treatment, and performance in specific departments such as 600:
said it was “completely shameful” that patients were being forced to resort to paying for operations the NHS should provide as these waiting times led to an increase of 53% between 2012 and 2016 in the numbers paying personally for private operations.
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government (1997-2010) had identified a requirement to promote improvements in A&E departments, which had suffered under-funding for a number of years. The target, accompanied by extra financial support, was a key plan to achieve the improvements.
485:, which only provides that patients can be lawfully detained for 24 hours, with a possible 12-hour extension. In December 2019 trusts in London were told to set up dedicated spaces to care for three mental health patients in every A&E department. 195:. The original target was set at 100%, but lowered to reflect clinical concerns that there will always be patients who need to spend slightly longer in A&E, under observation. Setting a target that, by 2004, at least 98% of patients attending an 84:
showed that concentrating on national targets led to managers deprioritising the safety and well-being of patients. Targets can benefit patients but they can also lead to bureaucracy, gaming and poor patient care, or as
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In Wales, as of January 2020 83.5% of patients were waiting less than six months to start hospital treatment. This is the lowest figure since December 2015 and was below the Welsh Government's 95% target.
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All across the UK the target is that patients should be treated within 62 days of an urgent referral, but the way this is measured varies. In Northern Ireland the target has not been met since 2015.
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some patients in Lancashire were “potentially being held against their will without appropriate legal provision”. Some were detained in seclusion rooms for more than a week under section 136 of the
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felt the targets had been successful in achieving their aim. "We feel, and maybe we are wrong, that one way we've managed to do that promote improvements in A&E is by setting a clear target".
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were set new "performance improvement trajectories". For 47 of the 140 trusts with "type one" major A&E facilities this meant a target of less than 95% waiting under 4 hours. In January 2017
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only 84.4% of patients were seen within four hours, the worst figure since the target was introduced in 2004. In November 2019 not a single A&E department hit the four-hour wait time target.
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acknowledges that the two nations targets are not directly comparable because "the Welsh population is older, sicker and more deprived than the English population—so its NHS has to work harder".
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Only 38% of hospitals met the target in 2019 and 22.5% of people waited longer than two months for their first treatment. In February 2022 10.7% of patients treated waited more than 104 days.
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February 2018 conceded that most of the targets would not be met before April 2019. The hospital care and A&E performance measures for October 2019 were the worst ever recorded.
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specifies waiting times in the accompanying Handbook, but does not provide a remedy should they be breached. Non-acute crisis response waiting time targets are to be introduced by
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Woodcock, Thomas; Poots, Alan J; Bell, Derek (March 2013). "The impact of changing the 4 h emergency access standard on patient waiting times in emergency departments in England".
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In Wales a year target is not measured but a nine month target is monitored. As of January 2020 25,549 patients (5.5%) had been waiting more than nine months to receive treatment.
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referrals should be seen within four hours. Mental health patients referred from emergency departments should be seen face-to-face by liaison teams within one hour.
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told the House of Commons on 10 July 2022 that ambulance service response time performance had improved month on month, but in fact it had deteriorated in June.
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In Northern Ireland more than a third of patients, 94,222 people, had waited more than a year for their first appointment in October 2018. According to the
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joint committee for mid and south Essex in December 2019 reported that local hospitals were “now working” to a 40-week referral to treatment target.
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Although the four-hour target helped to bring down waiting times when it was first introduced, since September 2012 (after the introduction of the
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in the 1990s – for example, guaranteeing a maximum two-year wait for non-emergency surgery and reducing rates of death from specific diseases.
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445,360 in England had been waiting six months or more by the end of December 2017 - three times more than in 2013. The President of the
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produced a report saying that the NHS needed at least 5,000 more beds to achieve safe bed occupancy levels and hit the four-hour target.
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Using queuing theory to analyse completion times in accident and emergency departments in the light of the Government 4-hour target
1654: 1188: 553:. 11.8% of those waiting for a procedure had waited 18 weeks or more. By March 2018 there were 2,647. The largest numbers were at 305: 205:
ailments could be excluded from the target and a new target introduced so the most urgent cases should be seen within an hour.
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different areas, with 25 times more patients waiting for heart operations in Birmingham and Solihull than in West Lancashire.
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The Welsh Government in 2019 became the first nation in the UK to have a single waiting times target for cancer treatment.
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announced that the 4 hour target was to be replaced by a new set of 10 metrics. The new “bundle of ten standards” includes
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broadly under-performed compared to the English NHS, with higher waiting times for both urgent and routine care. However a
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Clinically ready to proceed (time from when decision is made to admit or discharge, and patient is admitted or discharged)
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Critical time standards — aimed at ensuring the highest priority patients get care within a set timeframe such as an hour
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In December 2017 there were 1,750 patients waiting a year or more, the highest total since August 2012. 242 were at
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this performance has recently declined. In Scotland this target has dropped 5% between May 2018 and September 2019.
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and are less demanding than in the rest of the UK. None have been met since 2015, and some for considerably longer.
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The 70% two-hour response target was met at an all-England level but there were enormous variations between areas.
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suggest and it is doubtful that a single target (fitting all A&E and related services) is sustainable.
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said: “I can absolutely say there will be no changes to the target for four-hour waits in A&E.”
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establishes the treatment time guarantee, but also does not specify a remedy should it not be met.
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Performance in the first three months of 2019-20 was the worst since records began in 2011.
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Percent of patients in English A&E departments waiting over 4 hours, monthly, 2011-2018
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Over four million patients were waiting for non urgent hospital care as of July 2017. The
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Reducing avoidable trips (conveyance rates) to emergency departments by 999 ambulances
2514: 1826:"Northern Ireland NHS 'simply unable to cope with the demands placed on it': report" 1457: 1340: 1001:"Northern Ireland NHS 'simply unable to cope with the demands placed on it': report" 2231: 24: 2029:"Revealed: Secret stats show A&E crisis four times as bad as official numbers" 975: 1441: 1351: 1326: 317: 222: 201: 112: 77: 66: 20: 242:
Percentage of ambulance handovers (from ambulance to A&E) within 15 minutes
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applies: "When a measure becomes a target, it ceases to be a good measure".
28: 2183:"Cancer patients forced to wait 'unacceptably' long time for NHS treatment" 2161:"Pensions crisis and staff shortages trigger record low cancer performance" 1449: 1233:"Performance Watch: A sneak preview of a keenly awaited review of A&Es" 749:"Don't leave patients in ambulances to hit A&E targets, hospitals told" 708: 73:
Sajid Javid called for a ‘proper review of NHS targets’ in September 2021.
2227:"NHS patients waiting for hospital care top 4m for first time in a decade" 1090:
Edwards, Nigel; Trust, Chief Executive of the Nuffield (6 February 2015).
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the 52-week target had "not been completely achieved in over 11 years".
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According to the BMA the main reasons for not reaching this target are:
2117:"Check NHS cancer, A&E, ops and mental health targets in your area" 236: 192: 2405:"Numbers 'going private' for surgery soaring as NHS rationing deepens" 1919:"Revealed: Why one county saw a third of all 12-hour A&E breaches" 309:
immediately followed by a reduction in attainment to the lower level.
2449:"Huge discrepancy in NHS England waiting times for common procedures" 1897:"12-hour patient waits in A&E increase by 10,000% in five years" 1341:
BMA - BMA survey of accident and emergency waiting times, March 2005
1183: 1181: 2493:"Huge variation in referrals to flagship 'urgent response' service" 2427:"Two-year waiters for elective care up by half to just under 4,000" 1128:"NHS failed to meet four-hour A&E targets for past two months" 1063:"Wales introduces single waiting times target for cancer patients" 316: 177:
A four-hour target in emergency departments was introduced by the
168: 1142:"Third of providers will still miss A&E target in March 2017" 1281:"NHS England gives green light to drop four-hour A&E target" 1164:"Jeremy Hunt ditches four-hour target as A&E crisis deepens" 2471:"Last minute cancelled operations hits highest rate since 2005" 1303:"Recovery Watch: Will NHSE ever kill off the four-hour target?" 1023:"NHS Wales Delivery Framework and Reporting Guidance 2019-2020" 841:"Check NHS cancer, A&E and operations targets in your area" 803:
Connolly, Sheelah; Bevan, Gwyn; Mays, Nicholas (January 2010).
1545:"A&Es miss national objective with record low performance" 555:
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
52: 1734:"Ambulance waits hit two hours for heart attacks and strokes" 1633:"First quarter A&E performance worst since records began" 2361:"Trusts with the most two-year elective breaches revealed" 2339:"New fines for leaving patients waiting more than a year" 2295:"Year-plus elective waiters at highest number since 2012" 1875:"NHS needs 5,000 more beds, warn leading A&E doctors" 1539: 1537: 1327:
BBC NEWS | Health | Target 'putting A&E care at risk'
1211:"NHS chiefs look to scrap four-hour A&E maximum wait" 954:"Community services given first ever waiting time target" 245:
Time to initial assessment — percentage within 15 minutes
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Conservative government first set public targets for the
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The four-hour target triggered the introduction of the
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Average time in department — for non-admitted patients
2139:"Trust hits waiting time target in just 8pc of cases" 2095:"Summer crisis deepens as trolley waits hit new high" 1352:
BBC NEWS | Health | A&E success 'not sustainable'
863:"NHS allowed to miss A&E target for another year" 995: 993: 157:
report by the Chief Executive of the Nuffield Trust
665:Bevan, Gwyn; Hood, Christopher (16 February 2006). 571:
East Kent Hospitals University NHS Foundation Trust
2273:"Region 'working to 40-week target' for treatment" 1756:"Emergency performance slumps again as covid hits" 362:almost 10% between May 2018 and September 2019. 251:Average time in department — for admitted patients 33:Health and Social Care service in Northern Ireland 1336: 1334: 1322: 1320: 2521:Emergency medical services in the United Kingdom 1708:"Longest A&E waiting times hit a new record" 474:University Hospitals of North Midlands NHS Trust 1963:"Record collapse in emergency care performance" 257:Patients spending more than 12 hours in A&E 2073:"Trusts reveal thousands of new 12-hour waits" 1655:"SNP attacked over year of missed NHS targets" 1116:The Four Hour Target in Accident and Emergency 907:"Javid wants review of 'nonsense' NHS targets" 1800:"The challenge of change in the NHS in Wales" 1520:"NHS emergency care in crisis all year round" 8: 885:"Hospital waiting times at worst-ever level" 563:King's College Hospital NHS Foundation Trust 2253:. 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Evening Standard. 13 December 2019 976:"The NHS paid for my new French hip" 578:Royal College of Surgeons in Ireland 478:Lancashire Care NHS Foundation Trust 2526:Health policy in the United Kingdom 1189:"Trolley waits soar to record high" 447:Royal College of Emergency Medicine 1472:"Indicator: A&E waiting times" 1039:from the original on 19 April 2020 567:Royal Cornwall Hospitals NHS Trust 551:Royal Cornwall Hospitals NHS Trust 165:Accident and emergency departments 130:Patient Rights (Scotland) Act 2011 14: 2531:National Health Service (England) 2239:from the original on 1 July 2023. 747:Watts, Robert (27 October 2012). 19:are performance measures used by 2007:"Daily Insight: Unto the breach" 1657:. Scottish Express. 29 July 2018 1254:Jones, Simon (18 January 2022). 1849:"Focus on: A&E attendances" 430:In 2014, research conducted by 420:Not enough middle grade doctors 306:Health and Social Care Act 2012 2385:. Irish News. 29 November 2018 1061:Smith, Mark (27 August 2019). 646:NHS ambulance services targets 1: 434:, a joint programme from the 229:Response times for ambulances 2451:. Guardian. 1 September 2021 531:clinical commissioning group 389:Health and Social Care Board 343:National A&E performance 142:Health and Social Care Board 109:NHS Constitution for England 2407:. Telegraph. 11 August 2018 1522:. Sky News. 7 November 2018 1500:. King's Fund. 6 March 2017 1442:10.1136/emermed-2012-201175 1213:. Guardian. 2 December 2018 843:. BBC News. 7 December 2017 328:British Medical Association 239:that receive clinical input 235:Proportion of contacts via 2552: 1430:Emergency Medicine Journal 1260:Emergency Medicine Journal 1166:. Guardian. 9 January 2017 598:Royal College of Surgeons 526:Royal College of Surgeons 82:Stafford Hospital scandal 2185:. ITV News. 11 July 2019 683:10.1136/bmj.332.7538.419 2119:. BBC. 13 December 2018 1591:. BBC. 14 February 2019 887:. BBC. 14 November 2019 183:National Health Service 117:integrated care systems 978:. BBC. 3 December 2018 483:Mental Health Act 1983 322: 174: 928:Hunt, Jeremy (2022). 320: 294:acute assessment unit 172: 1371:Cass Business School 423:Department too small 283:Prime Minister Blair 179:Department of Health 321:A&E Attendances 98:National approaches 2235:. 10 August 2017. 1804:The Nuffield Trust 1714:. 20 February 2020 1373:. pp. 2, 34. 784:. Kings Fund. 2010 633:NHS Long Term Plan 627:Community services 462:Twelve hour target 411:Delayed discharges 396:Missing the target 323: 264:In September 2022 197:A&E department 175: 1806:. 18 January 2017 1380:978-1-905752-06-5 677:(7538): 419–422. 520:Planned treatment 445:In July 2017 the 440:Health Foundation 417:Not enough nurses 60:Labour government 2543: 2505: 2504: 2502: 2500: 2489: 2483: 2482: 2480: 2478: 2467: 2461: 2460: 2458: 2456: 2445: 2439: 2438: 2436: 2434: 2423: 2417: 2416: 2414: 2412: 2401: 2395: 2394: 2392: 2390: 2379: 2373: 2372: 2370: 2368: 2357: 2351: 2350: 2348: 2346: 2335: 2329: 2328: 2326: 2324: 2313: 2307: 2306: 2304: 2302: 2291: 2285: 2284: 2282: 2280: 2269: 2263: 2262: 2260: 2258: 2247: 2241: 2240: 2223: 2217: 2216: 2214: 2212: 2201: 2195: 2194: 2192: 2190: 2179: 2173: 2172: 2170: 2168: 2157: 2151: 2150: 2148: 2146: 2135: 2129: 2128: 2126: 2124: 2113: 2107: 2106: 2104: 2102: 2091: 2085: 2084: 2082: 2080: 2069: 2063: 2062: 2060: 2058: 2047: 2041: 2040: 2038: 2036: 2025: 2019: 2018: 2016: 2014: 2003: 1997: 1996: 1994: 1992: 1981: 1975: 1974: 1972: 1970: 1959: 1953: 1952: 1950: 1948: 1937: 1931: 1930: 1928: 1926: 1915: 1909: 1908: 1906: 1904: 1893: 1887: 1886: 1884: 1882: 1871: 1865: 1864: 1862: 1860: 1844: 1838: 1837: 1835: 1833: 1822: 1816: 1815: 1813: 1811: 1796: 1790: 1789: 1787: 1785: 1774: 1768: 1767: 1765: 1763: 1752: 1746: 1745: 1743: 1741: 1730: 1724: 1723: 1721: 1719: 1704: 1667: 1666: 1664: 1662: 1651: 1645: 1644: 1642: 1640: 1629: 1623: 1622: 1620: 1618: 1607: 1601: 1600: 1598: 1596: 1585: 1579: 1578: 1576: 1574: 1563: 1557: 1556: 1554: 1552: 1541: 1532: 1531: 1529: 1527: 1516: 1510: 1509: 1507: 1505: 1494: 1488: 1487: 1485: 1483: 1468: 1462: 1461: 1425: 1419: 1418: 1416: 1414: 1398: 1392: 1391: 1389: 1387: 1360: 1354: 1349: 1343: 1338: 1329: 1324: 1315: 1314: 1312: 1310: 1299: 1293: 1292: 1290: 1288: 1277: 1271: 1270: 1268: 1266: 1251: 1245: 1244: 1242: 1240: 1229: 1223: 1222: 1220: 1218: 1207: 1201: 1200: 1198: 1196: 1185: 1176: 1175: 1173: 1171: 1160: 1154: 1153: 1151: 1149: 1138: 1132: 1131: 1124: 1118: 1113: 1107: 1106: 1104: 1102: 1087: 1078: 1077: 1075: 1073: 1058: 1049: 1048: 1046: 1044: 1038: 1030:Welsh Government 1027: 1019: 1013: 1012: 1010: 1008: 997: 988: 987: 985: 983: 972: 966: 965: 963: 961: 950: 944: 943: 925: 919: 918: 916: 914: 903: 897: 896: 894: 892: 881: 875: 874: 872: 870: 859: 853: 852: 850: 848: 837: 831: 830: 828: 826: 820: 809: 800: 794: 793: 791: 789: 778: 772: 771: 769: 767: 744: 738: 737: 735: 733: 719: 713: 712: 702: 662: 383:Northern Ireland 136:Northern Ireland 2551: 2550: 2546: 2545: 2544: 2542: 2541: 2540: 2511: 2510: 2509: 2508: 2498: 2496: 2491: 2490: 2486: 2476: 2474: 2469: 2468: 2464: 2454: 2452: 2447: 2446: 2442: 2432: 2430: 2425: 2424: 2420: 2410: 2408: 2403: 2402: 2398: 2388: 2386: 2381: 2380: 2376: 2366: 2364: 2359: 2358: 2354: 2344: 2342: 2337: 2336: 2332: 2322: 2320: 2315: 2314: 2310: 2300: 2298: 2293: 2292: 2288: 2278: 2276: 2271: 2270: 2266: 2256: 2254: 2249: 2248: 2244: 2225: 2224: 2220: 2210: 2208: 2203: 2202: 2198: 2188: 2186: 2181: 2180: 2176: 2166: 2164: 2159: 2158: 2154: 2144: 2142: 2137: 2136: 2132: 2122: 2120: 2115: 2114: 2110: 2100: 2098: 2093: 2092: 2088: 2078: 2076: 2071: 2070: 2066: 2056: 2054: 2049: 2048: 2044: 2034: 2032: 2027: 2026: 2022: 2012: 2010: 2005: 2004: 2000: 1990: 1988: 1983: 1982: 1978: 1968: 1966: 1961: 1960: 1956: 1946: 1944: 1939: 1938: 1934: 1924: 1922: 1917: 1916: 1912: 1902: 1900: 1895: 1894: 1890: 1880: 1878: 1873: 1872: 1868: 1858: 1856: 1846: 1845: 1841: 1831: 1829: 1824: 1823: 1819: 1809: 1807: 1798: 1797: 1793: 1783: 1781: 1776: 1775: 1771: 1761: 1759: 1754: 1753: 1749: 1739: 1737: 1732: 1731: 1727: 1717: 1715: 1706: 1705: 1670: 1660: 1658: 1653: 1652: 1648: 1638: 1636: 1631: 1630: 1626: 1616: 1614: 1609: 1608: 1604: 1594: 1592: 1587: 1586: 1582: 1572: 1570: 1565: 1564: 1560: 1550: 1548: 1543: 1542: 1535: 1525: 1523: 1518: 1517: 1513: 1503: 1501: 1496: 1495: 1491: 1481: 1479: 1470: 1469: 1465: 1427: 1426: 1422: 1412: 1410: 1400: 1399: 1395: 1385: 1383: 1381: 1362: 1361: 1357: 1350: 1346: 1339: 1332: 1325: 1318: 1308: 1306: 1301: 1300: 1296: 1286: 1284: 1279: 1278: 1274: 1264: 1262: 1253: 1252: 1248: 1238: 1236: 1231: 1230: 1226: 1216: 1214: 1209: 1208: 1204: 1194: 1192: 1187: 1186: 1179: 1169: 1167: 1162: 1161: 1157: 1147: 1145: 1140: 1139: 1135: 1130:. 2 April 2013. 1126: 1125: 1121: 1114: 1110: 1100: 1098: 1089: 1088: 1081: 1071: 1069: 1060: 1059: 1052: 1042: 1040: 1036: 1025: 1021: 1020: 1016: 1006: 1004: 999: 998: 991: 981: 979: 974: 973: 969: 959: 957: 952: 951: 947: 940: 927: 926: 922: 912: 910: 905: 904: 900: 890: 888: 883: 882: 878: 868: 866: 861: 860: 856: 846: 844: 839: 838: 834: 824: 822: 818: 807: 802: 801: 797: 787: 785: 780: 779: 775: 765: 763: 753:Daily Telegraph 746: 745: 741: 731: 729: 727:The King's Fund 721: 720: 716: 664: 663: 659: 654: 642: 629: 620: 611: 594: 589: 539: 522: 504: 495: 476:. Problems at 469: 464: 455: 398: 385: 376: 368:Maria Caulfield 359: 350: 345: 315: 274: 219: 167: 150: 138: 126: 105: 100: 87:David Nicholson 58:The subsequent 45: 12: 11: 5: 2549: 2547: 2539: 2538: 2533: 2528: 2523: 2513: 2512: 2507: 2506: 2484: 2462: 2440: 2418: 2396: 2374: 2352: 2330: 2308: 2286: 2264: 2242: 2218: 2196: 2174: 2152: 2130: 2108: 2086: 2064: 2042: 2020: 1998: 1976: 1954: 1932: 1910: 1888: 1866: 1839: 1817: 1791: 1769: 1747: 1725: 1668: 1646: 1624: 1602: 1580: 1558: 1533: 1511: 1489: 1463: 1420: 1393: 1379: 1355: 1344: 1330: 1316: 1294: 1272: 1246: 1224: 1202: 1177: 1155: 1133: 1119: 1108: 1079: 1050: 1032:. March 2019. 1014: 989: 967: 945: 938: 920: 898: 876: 854: 832: 812:Nuffield Trust 795: 773: 739: 714: 656: 655: 653: 650: 649: 648: 641: 638: 628: 625: 619: 616: 610: 607: 593: 590: 588: 587:Six month wait 585: 538: 535: 521: 518: 503: 500: 494: 491: 468: 465: 463: 460: 454: 451: 436:Nuffield Trust 428: 427: 424: 421: 418: 415: 412: 409: 397: 394: 384: 381: 375: 372: 358: 355: 349: 346: 344: 341: 314: 311: 298:bed management 273: 270: 266:ThĂŠrèse Coffey 262: 261: 258: 255: 252: 249: 246: 243: 240: 233: 230: 218: 215: 166: 163: 149: 146: 137: 134: 125: 122: 104: 101: 99: 96: 92:Goodhart's law 44: 41: 13: 10: 9: 6: 4: 3: 2: 2548: 2537: 2534: 2532: 2529: 2527: 2524: 2522: 2519: 2518: 2516: 2494: 2488: 2485: 2472: 2466: 2463: 2450: 2444: 2441: 2428: 2422: 2419: 2406: 2400: 2397: 2384: 2378: 2375: 2362: 2356: 2353: 2340: 2334: 2331: 2318: 2312: 2309: 2296: 2290: 2287: 2274: 2268: 2265: 2252: 2246: 2243: 2238: 2234: 2233: 2228: 2222: 2219: 2206: 2200: 2197: 2184: 2178: 2175: 2162: 2156: 2153: 2140: 2134: 2131: 2118: 2112: 2109: 2096: 2090: 2087: 2074: 2068: 2065: 2052: 2046: 2043: 2030: 2024: 2021: 2008: 2002: 1999: 1986: 1980: 1977: 1964: 1958: 1955: 1942: 1936: 1933: 1920: 1914: 1911: 1898: 1892: 1889: 1876: 1870: 1867: 1854: 1850: 1843: 1840: 1827: 1821: 1818: 1805: 1801: 1795: 1792: 1779: 1773: 1770: 1757: 1751: 1748: 1735: 1729: 1726: 1713: 1709: 1703: 1701: 1699: 1697: 1695: 1693: 1691: 1689: 1687: 1685: 1683: 1681: 1679: 1677: 1675: 1673: 1669: 1656: 1650: 1647: 1634: 1628: 1625: 1612: 1606: 1603: 1590: 1584: 1581: 1568: 1562: 1559: 1546: 1540: 1538: 1534: 1521: 1515: 1512: 1499: 1493: 1490: 1477: 1473: 1467: 1464: 1459: 1455: 1451: 1447: 1443: 1439: 1435: 1431: 1424: 1421: 1408: 1404: 1397: 1394: 1382: 1376: 1372: 1368: 1367: 1359: 1356: 1353: 1348: 1345: 1342: 1337: 1335: 1331: 1328: 1323: 1321: 1317: 1304: 1298: 1295: 1282: 1276: 1273: 1261: 1257: 1250: 1247: 1234: 1228: 1225: 1212: 1206: 1203: 1190: 1184: 1182: 1178: 1165: 1159: 1156: 1143: 1137: 1134: 1129: 1123: 1120: 1117: 1112: 1109: 1097: 1093: 1086: 1084: 1080: 1068: 1064: 1057: 1055: 1051: 1035: 1031: 1024: 1018: 1015: 1002: 996: 994: 990: 977: 971: 968: 955: 949: 946: 941: 939:9781800751224 935: 931: 924: 921: 908: 902: 899: 886: 880: 877: 864: 858: 855: 842: 836: 833: 817: 813: 806: 799: 796: 783: 777: 774: 762: 758: 754: 750: 743: 740: 728: 724: 718: 715: 710: 706: 701: 696: 692: 688: 684: 680: 676: 672: 668: 661: 658: 651: 647: 644: 643: 639: 637: 634: 626: 624: 618:Cancellations 617: 615: 608: 606: 602: 599: 591: 586: 584: 581: 579: 574: 572: 568: 564: 560: 556: 552: 548: 544: 537:One year wait 536: 534: 532: 527: 519: 517: 514: 510: 507: 501: 499: 492: 490: 486: 484: 479: 475: 466: 461: 459: 452: 450: 448: 443: 441: 437: 433: 425: 422: 419: 416: 413: 410: 407: 403: 402: 401: 395: 393: 390: 382: 380: 373: 371: 369: 363: 356: 354: 347: 342: 340: 337: 334: 329: 319: 312: 310: 307: 302: 299: 295: 290: 286: 284: 279: 271: 269: 267: 259: 256: 253: 250: 247: 244: 241: 238: 234: 231: 228: 227: 226: 224: 217:New standards 216: 214: 210: 206: 203: 198: 194: 190: 187: 184: 180: 171: 164: 162: 160: 159:Nigel Edwards 156: 147: 145: 143: 135: 133: 131: 123: 121: 118: 114: 110: 102: 97: 95: 93: 88: 83: 79: 76:According to 74: 71: 68: 64: 61: 56: 54: 50: 42: 40: 38: 34: 30: 26: 22: 18: 2536:NHS Scotland 2497:. 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Index

NHS England
NHS Scotland
NHS Wales
Health and Social Care service in Northern Ireland
oncology
Major
NHS
Labour government
NHS England
Jeremy Hunt
Stafford Hospital scandal
David Nicholson
Goodhart's law
NHS Constitution for England
NHS England
integrated care systems
Patient Rights (Scotland) Act 2011
Health and Social Care Board
Full Fact
Nigel Edwards

Department of Health
National Health Service
acute
hospitals
England
A&E department
Jeremy Hunt
NHS England
NHS 111

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