NHS: Accident and Emergency Departments

Lord Hunt of Kings Heath Excerpts

Tuesday 5th February 2019 Lords Chamber

Asked by

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what is their response to the assessment of the President of the Royal College of Emergency Medicine that removing the four-hour accident and emergency treatment target would have a “near-catastrophic impact” on patient safety in many emergency departments.

[Baroness Manzoor (Con)]

My Lords, I note the concerns of the Royal College of Emergency Medicine and assure it, and the House, that patient safety remains paramount in any NHS care setting. As I mentioned in the excellent debate that the noble Lord, Lord Hunt, introduced last week, the NHS long-term plan will reform urgent and emergency care, and NHS England’s clinical review of standards will report its interim findings in spring 2019. Until then, we are clear that existing core access standards will remain in place.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am grateful to the Minister. She will know that, before the four-hour target was introduced, we had dangerously overcrowded A&E departments, very long waiting times and unsafe care generally. It is clear from the evidence that the chief executive of the NHS recently gave to a parliamentary committee that he wants the clinical standards review to get rid of the four-hour target under the guise of giving greater priority to the most urgent treatments. The problem with that is that most urgent treatments get priority already. There is a real risk that, if you let the four-hour target go, many patients will have to wait longer and longer. The royal college is concerned about patient safety. Is the answer not to invest in more beds and adult social care for frail, older patients and then get a more effective flow of patients through hospitals? In that way, the target could be met.

[Baroness Manzoor]

My Lords, the noble Lord is absolutely right: performance targets are important. However, we must ensure that the NHS is focusing on clinically appropriate targets. The clinical review of standards is considering standards for both physical and mental health. Following its interim findings, any recommended changes will be carefully field-tested across the NHS before they are implemented. An impact assessment will be published and changes to the NHS constitution will be consulted on, as is legally required.