This article is from the source 'bbc' and was first published or seen on . It will not be checked again for changes.

You can find the current article at its original source at http://news.bbc.co.uk/go/rss/-/1/hi/health/6267897.stm

The article has changed 6 times. There is an RSS feed of changes available.

Version 2 Version 3
A&E success 'not sustainable' A&E success 'not sustainable'
(10 minutes later)
A&E departments are struggling to sustain improvements to waiting times because of NHS deficits, doctors leaders warn.A&E departments are struggling to sustain improvements to waiting times because of NHS deficits, doctors leaders warn.
Doctors told the British Medical Association that lack of inpatient beds, staff shortages and people with minor complaints were to blame.Doctors told the British Medical Association that lack of inpatient beds, staff shortages and people with minor complaints were to blame.
A third of doctors surveyed said data was manipulated to ensure government targets were met.A third of doctors surveyed said data was manipulated to ensure government targets were met.
Since 2004, 98% of patients in A&E should be seen within four hours.Since 2004, 98% of patients in A&E should be seen within four hours.
Around 500 members of the British Association of Emergency Medicine responded to the BMA survey to investigate the impact of the four-hour target, which has been heralded as a success story by the government.Around 500 members of the British Association of Emergency Medicine responded to the BMA survey to investigate the impact of the four-hour target, which has been heralded as a success story by the government.
The level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis Mr Don MacKechnie, BMAThe level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis Mr Don MacKechnie, BMA
Almost half of respondents reported that their department was not meeting the target.Almost half of respondents reported that their department was not meeting the target.
And doctors raised concerns that even when targets had been met, departments had needed to use additional funding and agency staff on short term contracts to make sure patients were seen in time.And doctors raised concerns that even when targets had been met, departments had needed to use additional funding and agency staff on short term contracts to make sure patients were seen in time.
Government figures show that in 2005-06, 98.2% of patients were seen, diagnosed and treated within four hours of their arrival at A&E, the first full financial year in which this has happened.Government figures show that in 2005-06, 98.2% of patients were seen, diagnosed and treated within four hours of their arrival at A&E, the first full financial year in which this has happened.
However, 33% of respondents to the BMA survey reported that data manipulation was being used to meet the target. However, the BMA survey suggested that data could not be relied upon, due to manipulation of the figures.
The BMA said staff were working increasingly hard to maintain the improvements that had been made to waiting times with the vast majority reporting their workload had increased in the past 12 months.The BMA said staff were working increasingly hard to maintain the improvements that had been made to waiting times with the vast majority reporting their workload had increased in the past 12 months.
Almost all respondents said they had experienced direct or indirect pressure to meet the four-hour target.Almost all respondents said they had experienced direct or indirect pressure to meet the four-hour target.
Bed cutsBed cuts
Mr Don MacKechnie, chairman of the BMA's Emergency Medicine Committee said: "Many hospitals have cut bed numbers as part of their financial recovery plans and attempts to balance their books.Mr Don MacKechnie, chairman of the BMA's Emergency Medicine Committee said: "Many hospitals have cut bed numbers as part of their financial recovery plans and attempts to balance their books.
"This means that there are fewer available beds for patients coming through A&E who need to be transferred within four hours to a hospital ward from the emergency department to meet the Government's access target.""This means that there are fewer available beds for patients coming through A&E who need to be transferred within four hours to a hospital ward from the emergency department to meet the Government's access target."
He added: "Working towards the four-hour target on A&E waiting times has been a fantastic achievement, it has proved good news for patients and the extremely long waits seen in the last decade are now very rare.He added: "Working towards the four-hour target on A&E waiting times has been a fantastic achievement, it has proved good news for patients and the extremely long waits seen in the last decade are now very rare.
"However respondents tell us that despite this success, the level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis.""However respondents tell us that despite this success, the level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis."
Doctors also raised concerns about the effects of the target on clinical care with two-thirds saying that some patients are moved to inappropriate areas or wards and over half reporting that patients may be discharged before they had been adequately assessed or stabilised.Doctors also raised concerns about the effects of the target on clinical care with two-thirds saying that some patients are moved to inappropriate areas or wards and over half reporting that patients may be discharged before they had been adequately assessed or stabilised.
Previous surveys by the BMA have shown that many believe the target is set too high and that a lower goal of 95% of patients being seen within four hours would be more realistic.Previous surveys by the BMA have shown that many believe the target is set too high and that a lower goal of 95% of patients being seen within four hours would be more realistic.
Mr Martin Shalley, President of BAEM said: "Attendances at urban A&E departments continue to rise and pressure on beds remains a significant factor for achieving the four-hour target.Mr Martin Shalley, President of BAEM said: "Attendances at urban A&E departments continue to rise and pressure on beds remains a significant factor for achieving the four-hour target.
"It is vitally important to separate acute and elective facilities so that each can perform efficiently and improve the patient journey.""It is vitally important to separate acute and elective facilities so that each can perform efficiently and improve the patient journey."
A spokesperson for the Department of Health said fewer beds were needed because patients were being treated more efficiently.A spokesperson for the Department of Health said fewer beds were needed because patients were being treated more efficiently.
"But where the NHS needs more beds, there are more beds. Also, with fewer patients being kept in overnight, the number of day-only beds has increased by over 40% since 1997.""But where the NHS needs more beds, there are more beds. Also, with fewer patients being kept in overnight, the number of day-only beds has increased by over 40% since 1997."
They added: "Only four years ago, 25% of patients spent more than four hours in A&E. Now, 98.5% of patients are seen, diagnosed and treated within four hours.They added: "Only four years ago, 25% of patients spent more than four hours in A&E. Now, 98.5% of patients are seen, diagnosed and treated within four hours.
"This is a fantastic achievement that has transformed patient care, and is testimony to the hard work and professionalism of thousands of frontline NHS staff.""This is a fantastic achievement that has transformed patient care, and is testimony to the hard work and professionalism of thousands of frontline NHS staff."
The survey was sent to doctors throughout the UK but the majority of responses were from those working in England.The survey was sent to doctors throughout the UK but the majority of responses were from those working in England.
Targets were found to vary in other areas of the UK.Targets were found to vary in other areas of the UK.