NHS Hospitals Can Meet A&E Targets by Simply Moving Patients Between Waiting Areas Under Controversial New Guidance
The Labour Government faces accusations of cynically manipulating NHS performance figures through a controversial new policy that allows hospitals to meet A&E targets by simply moving patients from one waiting room to another. This administrative sleight of hand enables the government to claim improvements in emergency department performance, even when patients are not receiving faster treatment or higher quality care.
Redefining the Four-Hour Target Through Patient Transfers
Under current NHS England targets, 95 percent of patients should be treated, discharged, or admitted to a ward within four hours of arriving at an emergency department. However, official statistics reveal this target was met in just 73.8 percent of cases in December, the most recent month with available data. The new guidance instructs hospital bosses to establish dedicated waiting areas specifically for patients likely to require "extended" emergency care beyond the four-hour window but who will not need hospital admission.
The NHS England document explicitly states: "These facilities should be reserved for patients who are identified as requiring care, investigation or treatments, meaning the patient is likely to be in the ED for over four hours and, following this period of care, would then be discharged."
How the System Manipulates Performance Statistics
Critically, patients transferred to these newly designated "extended emergency medicine ambulatory care areas" within four hours of their A&E arrival will be counted as having met the flagship waiting time target. This statistical maneuver occurs despite the fact these patients have not actually been treated, discharged, or admitted to hospital wards. The guidance acknowledges this approach is likely to help hospitals achieve the elusive 95 percent target, which has not been reached since July 2015.
This revelation follows Conservative accusations last week that the government has been "massaging" routine care waiting lists by paying hospitals £3 million to delete hundreds of thousands of patients from records over six months, rather than providing actual treatment.
Medical Professionals Express Grave Concerns
The Royal College of Nursing and Royal College of Emergency Medicine have issued warnings that tens of thousands of patients are experiencing harm due to A&E overcrowding and treatment delays. Many receive what they describe as degrading and inhumane treatment while waiting on chairs and trolleys in noisy hospital corridors.
Dr Ian Higginson, President of the Royal College of Emergency Medicine, commented on the new guidance: "In isolation this document is unlikely to have meaningful impact on reducing overcrowding given that it relates to only one piece of the jigsaw. Overcrowding and corridor care is ultimately driven by our inability to find beds for patients who need to be in hospital – this is because hospitals are full."
Political Criticism and Government Defense
Tory MP Stuart Andrew, the shadow health secretary, launched a scathing attack: "Labour isn't improving A&E performance, it's moving patients from one waiting area to another and calling it success. Redefining the four-hour target doesn't mean patients have been treated, admitted or discharged. It just means the figures have been massaged while people continue to wait for care."
Andrew continued: "We've already seen Labour quietly remove patients from elective waiting lists to make the numbers look better. Now the same trick is being used in A&E, shifting people around instead of fixing the problem. Wes Streeting needs to stop obsessing over replacing Keir Starmer and stop playing games with the statistics. His focus should be on patients."
Julian Redhead, NHS England's National Director of Urgent and Emergency Care, defended the approach: "We are supporting hospitals to better manage their flow of patients in A&E and speed up care for patients."
Health Secretary Wes Streeting offered his perspective: "Too many patients are stuck waiting in overcrowded A&Es when they could be treated faster and more safely elsewhere. This new model will put senior clinicians at the front door, get people the right care in the appropriate place and free up A&E to focus on life-saving treatment."
Root Causes of the A&E Crisis
The ongoing emergency department crisis has been largely attributed to bed-blocking issues, with thousands of hospital beds occupied by patients declared medically fit for discharge but unable to leave due to delays in arranging home care or care home placements. This systemic bottleneck prevents new patients from being admitted from A&E departments, creating dangerous overcrowding and treatment delays throughout the emergency care system.
