Press release: scrapping of four-hour target must not be a response to continual failure of the Government to meet targets as waiting times spiral says DAUK

Scrapping of 4 hour target must not be a response to continual failure of the Government to meet targets as waiting times spiral says DAUK

NHSE will be launching a consultation into the current four-hour target in emergency departments across the NHS. Doctors’ Association UK has been invited to be one of the expert groups providing input in this consultation. This is an extension of the current review, which began in 2018 and was due to conclude in Spring 2020 but was delayed by the COVID-19 pandemic.

The four-hour target has been a contentious point amongst health professionals working in emergency medicine for many years. Whilst it has allowed an increase in focus and funding for A+E departments that was previously lacking prior to its introduction, it has at times been a blunt and sometimes misleading measurement. Despite this there have so far been no viable alternative targets suggested. After several years of this target largely being ignored as a metric – The NHS has not met the four-hour standard at national level in any year since 2013/14, and the standard has been missed in every month since July 2015. Between 2011/12 and 2018/19, A&E attendances grew on average by 2.1 per cent each year and increased by 3.3 million (16 per cent) in total. This is the equivalent of an extra 9,200 A&E attendances each day. Given this increase – alternatives need to be evaluated to ensure optimal patient care.

Dr Samantha Batt-Rawden, President of the Doctors’ Association UK and a senior registrar in emergency and intensive care medicine said: 

“The 4-hour target is considered by many frontline doctors as not fit for purpose, with patients continuing to wait hours in Emergency Departments this winter as in many recent winters. 

We are pleased that NHS England is launching this consultation in partnership with frontline staff to develop alternative patient-focused targets; going forward we must ensure that these are backed up with the staff and resources to achieve them. 

Doctors have repeatedly told us of dire working conditions on the frontline. NHS staff are working themselves into the ground to keep patients safe during the worst winter on record. We must ensure that this move is not an attempt to deflect accountability for spiralling wait times in Emergency Departments as a result of years of under-resourcing.”

Doctors’ Association UK looks forward to working with NHSE and other expert groups to ensure that measures of emergency department performances focus on patient safety and quality of care as well as efficient treatment.

Read the ‘Transformation of urgent and emergency care: models of care and measurement’ report on the NHS England website, now publicly available here.



1The Doctors’ Association UK (DAUK) is a professional association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession