Hospitals freeze A&E targets - because they can’t hit them

Doctors warn that the best they can do now is try to prevent patients waiting for 12 hours, not four

Hospitals across Britain have been forced to suspend targets to see accident and emergency patients within four hours because they can no longer cope with demand, doctors and managers have warned.

In a stark assessment of the crisis facing the NHS, the professions’ leaders said that pressures on the system meant the best hospitals could do was to try and prevent patients waiting for up to 12 hours for treatment.

They told MPs on the Health Select Committee that the crisis in A&E reflected an “inability” of the whole NHS to meet the demand and called for urgent action to improve care for patients in the community.

In the House of Commons senior Conservative and Labour politicians became embroiled in a blame game over who was responsible for the crisis. The Health Secretary Jeremy Hunt blamed the previous Labour Government for allowing GPs to opt out of after hours care which has resulted in an increase in patients attending A&E units.

He admitted that “short-term pressures” could result in NHS not coping “as well as it needs to and affecting the “quality of care”. But he added that responsibility lay with “target-at-any-cost culture under Labour” which “led to the disaster of Mid-Staffordshire”.

“We will take responsibility for sorting out those problems, but the Labour party must take responsibility for creating a number of them,” he said.

His Labour counter-part Andy Burnham rejected the allegations and accused Mr Hunt of failing to deal with the crisis. “The truth is that this is a mess of the Government’s own making,” he said. “It will not be solved by the Secretary of State’s spin or by blaming GPs. He has been found playing politics when he should be dealing with the real causes of today’s chaos.”

In evidence to MPs earlier in the day, Dr Mike Clancy, president of the College of Emergency Medicine, said that some hospitals had effectively given up trying to treat A&E patients within four hours and were concentrating on the 34,000 patients a year waiting between four and 12 hours.

“The deterioration in four-hour performance has reflected the pressure the system is under,” he said. “What has happened is that organisations are now focusing more on how many people waiting up to 12 hours, and have in a sense parked the four-hour target because it is so difficult to manage.”

He said the problems reflected a “major workforce workload imbalance” and an “inability of the whole system to meet the demand”. In the last decade there has been a 17 per cent increase in patients attending major A&E units.

“What is happening in emergency departments reflects the performance and difficulties of the whole NHS as well as within the emergency department,” he said. “It is the overcrowding of emergency departments that is one of the major challenges that we face, because you should know that is dangerous – there is associated mortality and morbidity associated with overcrowding.”

Mike Farrar, chief executive of the NHS Confederation warned that the problems could have a knock-on effect on elective surgery. “A lot of this emergency capacity has taken away the opportunity that the trusts had to do their elective work,” he said.