What Would It Look Like If NHS Patients Had To Book A&E Appointments?

NHS chiefs could be about to ditch four-hour waiting targets.
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A shake up of NHS waiting targets could lead to patients having to book an appointment to visit A&E, it has been claimed.

The Guardian reported on Thursday that many of England’s 22 million annual A&E visitors could be asked to pre-book if supposed plans to relax the NHS’s long-standing aim to see 95% of A&E patients within four hours go ahead.

It comes after Theresa May launched a review into NHS waiting times as part of a long-term plan for the NHS, with the health service’s pledge to give non-urgent patients surgery within 18 weeks also under consideration.

NHS England chief executive Simon Stevens did little to dispel rumours the target is destined for the scrapheap when speaking to the Health Service Journal in July.

Asked if the target was fit for purpose, he said: “There have been significant clinical practice changes in urgent and emergency care pathways over the years.”

But what would it actually mean for NHS patients if they had to make an appointment to visit A&E?

Although it’s hard to say how it might work in the UK, parts of Denmark already worker under such a model, including the capital of Copenhagen.

While residents of the city are advised to call 112 – the equivalent of 999 in Europe – in cases of “life-threatening” injury, they are told to contact another emergency helpline staffed by doctors and nurses before heading to A&E.

Warning that patients who turn up at emergency clinics without calling for a referral should expect delays, official advice explains that those who do use the helpline will be given a time for an appointment and will be able to wait at home.

But such proposals are likely to spark controversy among medics. The Royal College of Emergency Medicine has repeatedly voiced its support for a four hour A&E target, calling it “an indicator of how safe the system is”.

Revising the target downwards is like disconnecting a flashing engine warning light on a car rather than getting it fixed – it ignores the potential dangers and unnecessarily puts safety in jeopardy,” the college said in a statement earlier this year.

“It is the cheap “fix” rather than the right and safe one.”

NHS England declined to comment on the reported plans.

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