Targets and achievements

The Daily Telegraph yesterday reported the results of a survey of 1,000 hospital and community nurses by the Nursing Times.

In reveals that in A and E departments 40% of nurses claimed that colleagues are adjusting times of arrival and departure of patients to meet the four hour target. Of the respondents, 10% said that they had been asked to falsify the figures in this way.

Even the NHS official data show that many patients are being transferred to a ward, corridor or observation area in the last ten minutes of the four hours.

The Department of Health stressed that misreporting or manipulation is a very serious offence, and require immediate and robust investigation.

What do they expect? For many people the out-of-hours service is not good, and so A and E is the immediate recourse if they have a problem. The A and E service is overloaded and has peak demands which cannot be met with the staff available. In many cases they are dealing not with accidents but with social problems such as binge drinking.

The problem is with the armchair decisions made in remote Whitehall. Hospital staff have to cope on the ground. While they may have slacker periods, they also have long periods, especially on Friday and Saturday evenings, when there are so many serious cases that targets are meaningless. We even had the cases of patients waiting outside in ambulances, to delay the recorded time of arrival.