I think it was as far back as 2013 that I last wrote about targets in the NHS. Not that they have ever been very far away but once again they are all over the news.
Apparently, nearly one in five NHS hospital services has failed to hit any key national waiting-time targets in the past year. This refers to three key areas: accident and emergency; cancer; and routine operations.
Should we be worried? Perhaps, but in truth I don’t know. What we are not told is by how much these targets were missed, what were any mitigating circumstances or how relevant the target is to the patient, the ultimate arbiter of good service.
Take the A&E target time of 4 hours for example. The operational standard is that at least 95% of patients attending A&E should be admitted, transferred or discharged within four hours. Why 4 hours? Why 95%?
Whenever I have attended A&E this has been the least of my worries. I have been far more interested in the efficacy of the treatment, the speed at which I have first contact with a medical professional and the quality of the care rather than how long it took me from entry to exit.
If targets were set that related to what the patient wanted then perhaps the ‘failed’ hospitals may well have done better. Again I don’t know.
On the other hand, perhaps the target are set at a level where failure is expected. NHS England warned hospitals earlier in the year that they would need to start using private providers to bring down waiting lists if they could not cope.
Beware, the setting of irrelevant and impossible targets may well just be a political ruse to undermine the public provision of healthcare. Perhaps, but in truth I don’t know.