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RCEM responds to Secretary of State’s comments around the four-hour A&E target

22 September 2022

Responding to a comment made by the Health and Social Care Secretary and Deputy Prime Minister Thérèse Coffey in which she stated she has no plans to change the four-hour A&E target, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“At the moment we are desperate to improve patient experience in our Emergency Departments and if that means renewed scrutiny on the four-hour access standard and action to improve it we would be cautiously supportive. For months we have been stuck in a performance vacuum in which metrics, like the four-hour standard, have simply been documenting a system failing to function as it should and failing patients. Patient care is at the heart of all we do, and so meaningful measurement of performance must drive improvement and better care for patients.

“It came as a surprise to hear the Health Secretary rule out replacing the four-hour target with a meaningful basket of measures as detailed by NHS England in the Clinical Review of Standards, which began in 2019. We engaged with this process in good faith. Pilot sites of the CRS, currently excluded from publishing their four-hour data, must be included in the national data immediately so that all hospitals are represented.

“Our priority has always been to transform clinical and patient care through trustworthy metrics that drive improvement. The four-hour target has not been met since 2015 and its power to drive improvement stagnated. We would welcome a recommitment to and refocus on the four-hour target in the short-term, bearing in mind that doing the same thing whilst expecting different results is pointless. The goal must be to meaningfully drive improvement and better patient care, backed up by more than lip-service.”

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