Key points ■ NHS England plans to abolish the 4-hour emergency department target ■ The target has been criticised as lacking a clinical rationale. ■ Research has shown that long waits for admission are associated with increasing patient mortality. ■ The target is appropriate and clinically relevant: it should not be abolished, and hospitals and NHS England should make renewed efforts to meet it.
such as diverting patients away from emergency departments. This does not seem to have a notable effect on attendance and, even if it did, would have little impact on performance.
NHS England has proposed abolishing the 4-hour metric and replacing it with a range of other – much less useful – metrics. Given the relationship between long waits and mortality, NHS England should abandon its attempts to obfuscate the key metrics for emergency departments and refocus its efforts to understand the causes of long waits and eliminate them, as should hospital managers.
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British Journal of Hospital Medicine | March–April 2022 | https://doi.org/10.12968/hmed.2022.0090