Trooper wrote:
The problem is that all problems aren't equal. Waiting 5 hours for something that wasn't critical and has no lasting effects? Sure it sucks for the specific people involved, but it isn't that important as a whole. The key measure i'm interested in is how quickly do they see people who are critical and where time is of the essence. Are there figures for that?
Sure. But again: what's shown in that graph is a significant degradation in response times in A&E; it's certainly a service that is performing worse for the average user.
Furthermore, unless A&E is handling significantly more non-urgent cases in the last five years than it did in the five years before it, then it seems reasonable to assume that there are critical cases taking longer too, simply by the law of averages. Now one hypothesis is that A&E *is* handling significantly more non-urgent cases, mostly because the coalition has cut funding for things like non-urgent walk-in centres and GP offices, forcing more people into the (much more expensive) A&E channel. But that's hardly a robust defence of the sitting government's ability to manage healthcare either.
ApplePieOfDestiny wrote:
Agreed - my point being that the metric is bollocks - as the key outcome there is whether the manipulation of performance, to see someone at 3 hrs 50 to meet the target, is at the expense of a critical case. I'd hope it is unlikely.
Two things. Firstly, I don't think that metric is any more fallacious than a number of others I've worked under myself. I only see two options in process management: apply flawed metrics or don't measure anything. I'd much rather apply flawed metrics, cautiously and with one eye on their shortcomings, than rely on gut feel alone.
Secondly, this is one of the government's chosen headline metric, so judging it by its performance against it doesn't feel unreasonable to me.
Malc wrote:
Going back to the original post, the thing that stuck me was that they were saying "worst performance for..."
I thought they were going to say something like "...50 years" or something, but they actually said "...10 years".
10 years? 2005. I don't recall there being a big hoohah then about waiting times being really bad or anything. It seemed to me like they had an agenda the way they were presenting it.
My understanding was that these figures have only been tracked this way since 2005, so that's all the data they have. So another way of putting it is "the worst performance since records began."
flis wrote:
Isn't there a bit of a difference between "being seen within 4 hours" and "being discharged/admitted within 4 hours"...?
The reason the metric focusses on discharge or admission, to my understanding, is because until that happens you're still consuming A&E resource: nurse time, doctor time, tests being run, and so on. And A&E is really expensive to run so it's in everyone's interests to get people shunted on to the correct destination as quickly as possible.