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NHS chief backs call for tougher, faster A&E waiting-time standards

NHS chief backs call for tougher, faster A&E waiting-time standards

A “tougher and faster” set of waiting-time standards is needed for some patients attending accident and emergency departments, the NHS England chief executive has said. The four hour A&E waiting-time target was not well understood, Simon Stevens said on Monday as he discussed the the NHS’s £20bn 10-year plan, which will launch on Monday, pledging…

A “tougher and faster” set of waiting-time standards is needed for some patients attending accident and emergency departments, the NHS England chief executive has said.

The four hour A&E waiting-time target was not well understood, Simon Stevens said on Monday as he discussed the the NHS’s £20bn 10-year plan, which will launch on Monday, pledging to transform the health service.

Stevens told BBC Radio 4’s Today programme: “On A&E services, we think we actually need a tougher, faster set of standards for some major conditions than we’ve got at the moment.

“The four-hour target is not terribly well understood – people think it’s four hours to start treatment. It’s actually four hours to have been assessed, to have your tests done and for the treatment to have been completed, and, if it hasn’t been, for you to be admitted to a hospital in-patient bed.

“The problem with that is it doesn’t distinguish between turning up at A&E with a sprained finger versus turning up with a heart attack.”

He said senior doctors were advising that the standards should focus particularly on major conditions, such as sepsis, heart attacks and strokes.

“At the other end of the spectrum, there are conditions for which previously you would have had to be admitted and stay overnight in hospital, but you can now actually have your care sorted out on the same day.

“The top doctors in the NHS are looking at what are the most appropriate clinical standards to improve outcomes in emergency care. They will make their recommendations and, on the back of that, we will meet them,” he said.

Details of how the NHS intends to dramatically reduce the number of people dying from big killers, such as cancer, heart attacks and strokes, will be set out in the 10-year plan.

It will explain how the NHS will spend the extra funding May announced last year, to mark its 70th birthday, which will increase the budget in England from £115bn to £135bn by 2023-24.

Experts have said the plan must avoid presenting an undeliverable wish list that makes too many promises and sets up the NHS to fail.

However, Stevens said: “That is not what we have got. I know we have not got that as the plan has been drawn up by leaders of hospitals, nurses, senior doctors, patients’ groups and by the NHS itself.”

Asked how the NHS could respond to Philip Hammond’s demand for cuts in waste, Stevens said: “[The chancellor] is quite right about that. The good news is we have one of the most efficient health services in the world, but that doesn’t mean we can’t do better.”

He added: “Productivity in the NHS has been growing faster than across the economy as a whole over the last several years. We have a very efficient health service, but everybody can see we can be more efficient.”

The NHS chief also said the NHS was working closely with the government to avoid disruption to healthcare as a result of Brexit.

“We have been focusing particularly on medicines supply,” he said. “That’s obviously closely linked to the availability of good transport arrangements post-Brexit, including freight by sea and air.

“The Department of Health and Social Care, which leads on this, are working very closely with us to put in place contingency plans.”

Asked what the impact of Brexit would be on staffing, Stevens said: “We’ve got about 5% of NHS staff that come from the rest of the European Union. That’s very important, 65,000 people.

“It’s crucial that we are able to provide the reassurance that they continue to be immensely important and very welcome going forward.

“It will clearly be important that we have a sensible approach to being able to continue to recruit internationally to the NHS, alongside the expansion in domestically trained staff.”

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