Matt Hancock Hints NHS A&E Waiting Times Could Be Scrapped

Health secretary says there is a ‘problem’ with the current four-hour ambition
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Health secretary Matt Hancock has hinted that landmark NHS targets could be scrapped following the health service’s worst A&E waiting times since records began.

More than one in five patients were forced to wait for more than four hours for treatment in December.

But Hancock said there was a “problem” with the target as it failed to take into account other improvements.

NHS England figures published last week showed just 79.8% of A&E patients were seen within the specified time, way below the 95% target that was introduced by Tony Blair’s government in 2004.

The Royal College of Emergency Medicine said that the dire statistics were proof of a “miserable Christmas” for patients and staff as nearly 100,000 people were forced to wait on trolleys over four hours - and more than 2,000 people waited over 12 hours for a hospital bed.

But when quizzed by BBC Radio 5 Live on whether the Tory government should be judged by NHS targets, Hancock said: “We will be judged by the right targets”.

Asked if that meant “there’s the right targets and the wrong targets?” he replied: “That’s right... because targets have to be clinically appropriate.

“The four-hour target in A&E which is often taken as, and has been in the past, taken as the top way of measuring what’s going on in hospitals.

“The problem with that target is that increasingly people can be treated on the day and able to go home. That is much better for the patient. It’s also better for the NHS and yet the way that that’s counted in the target doesn’t work.

“So it’s far better to have targets that are clinically appropriate, supported by clinicians so we’ve got clinicians looking at that. It’s best if that is led by the doctors.”

NHS England Medical Director Steve Powis is currently leading a review of NHS targets, but ever since David Cameron was PM ministers have long been wary of the political backlash that could follow from being seen to change the goalposts.

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Jon Ashworth, Labour’s shadow health secretary, said changing the target would not “magic away the problems in our overcrowded hospitals, with patients left on trolleys in corridors for hours and hours”.

“Any review of targets must be transparent and based on watertight clinical evidence, otherwise patients will think Matt Hancock is trying to move the goalposts to avoid scrutiny of the government’s record,” he said.

“After years of austerity under the Tories, the government’s first priority must be to give the NHS the funding and staff it needs to end the waiting time crisis.”

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said: “So far seen we’ve seen nothing to indicate that a viable replacement for the four-hour target exists and believe that testing should soon draw to a close.

“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”

Dr Simon Walsh, emergency medicine expert at the British Medical Association, said: “Ultimately, replacing targets does not address the fundamental issues of capacity and resourcing within the NHS/”

Many doctors believe that although the four-hour target can be a blunt instrument, it forces the system to avoid longer waits that can lead to patient harm.

One doctor swiftly accused Hancock of wanting to “bin” the current targets.

When asked to comment on remarks by former Society for Acute Medicine president Dr Nick Scriven that failure to meet targets has been “normalised” by this government, Hancock disagreed.

“I would challenge this idea that there hasn’t been improvements. There’s been massive improvements in the way that the NHS delivers care for instance, the proportion of people who are now cared for and treated on the same day, and can get home at night instead of having to stay overnight in hospital that proportion has increased.

“This year, 2019, the number of people treated in A&E departments has gone up by over a million.”

Other missed targets include one in six ambulance crews had to queue outside any units more than 13 minutes, 690,000 patients waiting more than 18 weeks for non-urgent surgery, the highest since 2008. Some cancer waiting targets have not been hit since 2016.

Hancock said some of the statistics were “important and which we are gripping” but stressed “people in the NHS are delivering more services to people than ever before”.

“The best response to these challenges, which are all all stem from increased demand for the NHS, is to ensure that increased funding in the NHS and today we are delivering on our manifesto commitment to put into law, the record some £33.9 billion that’s going into the day to day running of the NHS.”

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