People share what a good A&E experience looks like

Healthwatch | October  2019 | People share what a good A&E experience looks like

New research from Healthwatch  shows that the public value a wide range of factors when it comes to good care in A&E; Healthwatch polled 1700 people in July and October of this year about what they thought about the four-hour A&E waiting time target.

The NHS is currently reviewing this measure as well as other national targets in elective care, cancer, and mental health, to reflect the changing environment so that people receive the best possible care.

The NHS Access Standards Review proposal includes:

  • The introduction of average waiting time measures. This would mark a move away from maximum waiting times, such as the four-hour A&E target and 18-week target for routine operations.
  • New measures to support faster initial assessment and treatment for those with the most urgent needs.

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Healthwatch reports that:

  • Awareness of current targets is low
  • People aren’t clear when the clock starts ticking
  • Average waiting times are easier to understand and more helpful
  • Waiting times are less important to people than other aspects of their experience
  • One in ten are happy to wait ‘as long as necessary’ to be treated and discharged for a non-urgent condition
  • Although many people visit A&E without seeking external advice, most are advised to attend by another service
  • Most people are not told how long they should expect to be in A&E when they arrive
  • Time in the department is the not the best indicator of people’s overall experience of A& E.

Healthwatch asked the people they surveyed to rate a series of factors based on what they think should be prioritised in A&E.

1. Prioritise treating patients with the highest level of need (89%)

2. Deliver the right tests and treatment within an hour where people are thought to have a life-threatening condition (88%)

3. Assess patients quickly on arrival so that their level of need can be determined (86%)

4. Offer pain relief while waiting if appropriate (71%)

5. Give people an estimated waiting time on arrival and informing them of any changes (65%)

6. Ensure staff are on hand to provide support while people wait to begin treatment (63%)

7. Admit or discharge all patients as soon as possible (62%)

8. Make information about current waiting times available to people before arriving at A&E and provide information on alternative services (59%)

9. Make sure that people who have been in the A&E department the longest are prioritised (50%)

10. Communicate to patients that a safe number of staff are working (49%)

11. Help people to avoid being admitted to a hospital ward overnight wherever possible, even if that means they spend longer in A&E (48%)

12. Admit or discharge a set proportion (currently 95%) of patients within a set timeframe (currently four hours) (46%)

The percentages reported reflect the proportion of people who gave each factor a high priority rating (4+ on a scale of 1-5).

The four-hour A&E waiting time target was brought in 15 years ago and sets out a national standard that at least 95% of patients attending A&E should be admitted, transferred or discharged within four hours.

The NHS is reviewing this measure as well as other national targets in elective care, cancer, and mental health, to reflect the changing environment so that people receive the best possible care.

The NHS Access Standards Review proposal includes:

  • The introduction of average waiting time measures. This would mark a move away from maximum waiting times, such as the four-hour A&E target and 18-week target for routine operations.
  • New measures to support faster initial assessment and treatment for those with the most urgent needs.

See also:

NHS England Public back NHS plans for new rapid care measures

A Guide to Managing Medicines Supply and Shortages

NHS England | November 2019| A Guide to Managing Medicines Supply and Shortages

NHS England have produced a guide which aims to support pharmacists, clinicians and other NHS professionals with managing the supply of medicines to their patients and details the national, regional and local management and escalation processes and communication routes for medicines supply issues in order to consolidate existing practice across industry, government and the NHS (Source: NHS England).

A Guide to Managing Medicines Supply and Shortages