Patients are waiting longer in A&E departments due to a wide range of factors including rising demand for services and reduced capacity to meet this demand. The 2020 national survey of patients who have used urgent and emergency care services also shows these services receive high satisfaction scores overall, although, for example, more can be done to improve communication with patients as they are discharged from A&E. However, measuring the proportion of people seen within four hours does not provide a full picture of how A&Es are performing and we should be cautious about placing too much emphasis on the four-hour standard or any single measure of A&E performance. For example, patients cannot be admitted quickly from A&E to a hospital ward if hospitals are full due to delays in transferring patients to other NHS services or in arranging social care. This is because A&E waiting times are affected by activity and pressures in other services such as the ambulance service, primary care, community-based care and social care services. The new standards were piloted in 14 NHS trusts and are expected to be rolled-out nationally.Ī&E waiting times are often used as a barometer for overall performance of the NHS and social care system. The review proposed replacing the four-hour standard with a new basket of standards, including measures of how long patients wait before assessment or treatment in A&E. In 2018, NHS England began a review into NHS access standards including the four-hour A&E standard. In 2010 the standard was relaxed, and the percentage of patients expected to be discharged, admitted or transferred was reduced from 98 per cent of patients to 95 per cent of patients. The four-hour standard measures the total time patients spend in A&E from the time they arrive to when they leave the department to be admitted, transferred or discharged, rather than the time patients spend ‘waiting’ for treatment to begin or the time before they are ‘seen’. ![]() The four-hour standard is monitored for attendances at all types of A&E departments, including A&E services provided by the independent sector for NHS patients. The four-hour standard was introduced by the Labour government in the early 2000s.
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