Responding to the news that key waiting times targets for planned treatment are to be scrapped, and the A&E target is to be reviewed, Nuffield Trust Chief Executive Nigel Edwards said:
“It is very welcome that the 18-week target for planned treatment is to be simplified, reducing the number of targets from three to one. Focusing on those still waiting for treatment, rather than the numbers of patients treated within a given timeframe, makes perfect sense. This should provide a more patient-focused measure of care.
"Our recent analysis revealed that problems meeting the 18 week referral to treatment target and the four-hour A&E target over the past year has affected both the best and worst performing hospitals, suggesting these problems are systemic rather than due to local or managerial failings. This highlighted the need to have a more nuanced approach to managing hospital performance."
“Moreover, we have raised real concern over the negative impact that the reporting culture associated with multiple and high profile targets can have on staff behaviour and, ultimately, on care quality.
We hope that this review will be accompanied by a more collaborative and less punitive approach from regulators and government when considering NHS performance.
“The proposal to consider the four-hour A&E target alongside other clinical measures is therefore also a very positive development. Our analysis suggests this target – which has come to loom above all others in significance – should be viewed alongside richer indicators such as time to treatment, four-hour ‘trolley waits’, and seven-day readmission rates.
“Monitoring hospital performance remains key, and the replacement of weekly A&E figures with a monthly publication of indicators for many targets should help us understand changes in performance in a more meaningful way. We hope that this review will be accompanied by a more collaborative and less punitive approach from regulators and government when considering NHS performance.”
Notes to editors
- In a new briefing aimed at the Conservative Government, the Nuffield Trust recently called for a review of the effectiveness of performance targets in the NHS, on the basis that targets can distort priorities and detract from patient care.
- The Nuffield Trust’s analysis Access to hospital care: is the NHS on target?, published in March looked at how hospitals have performed against six key indicators, including two planned treatment targets and the four-hour A&E target. In it we highlighted the systemic problems affecting hospital performance. The analysis was authored by Holly Dorning and Ian Blunt.
- Our briefing on the A&E ‘crisis’ , published in March 2015, argued that the disproportionate focus on the four-hour A&E target called for the A&E target to be relegated in importance and viewed alongside a richer set of indicators.