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The King’s Fund has reported that the proportion of patients being seen within the four hour target in hospital emergency departments in England still meets the government target of 95%(1). Appearances can be deceptive.
In a recent study of data collected from our nearest hospital by the local Clinical Commissioning Group as part of its preparation to assume responsibility for commissioning in the next year it was a surprise to find that a large rise in admissions occurred in the final hour of the 4 hour target, and an unexpectedly large number of those admitted was discharged from the hospital within a few hours. The study noted that an “admission" of this sort generates a fee to the hospital six times greater than for a simple emergency department attendance, even if the patient leaves shortly afterwards (personal communication).
The current commissioners (the Primary Care Trust) either have not noticed how the fees are earned or are acquiescent in what appears to be financial and target gaming by the hospital Trust. The waste of public money in this way may help the two Trusts to meet their target and secure the hospital's financial position with impunity but it damages other parts of the local health economy. Who guards the guards?
Re: Waiting times in English emergency departments reach eight year high
The King’s Fund has reported that the proportion of patients being seen within the four hour target in hospital emergency departments in England still meets the government target of 95%(1). Appearances can be deceptive.
In a recent study of data collected from our nearest hospital by the local Clinical Commissioning Group as part of its preparation to assume responsibility for commissioning in the next year it was a surprise to find that a large rise in admissions occurred in the final hour of the 4 hour target, and an unexpectedly large number of those admitted was discharged from the hospital within a few hours. The study noted that an “admission" of this sort generates a fee to the hospital six times greater than for a simple emergency department attendance, even if the patient leaves shortly afterwards (personal communication).
The current commissioners (the Primary Care Trust) either have not noticed how the fees are earned or are acquiescent in what appears to be financial and target gaming by the hospital Trust. The waste of public money in this way may help the two Trusts to meet their target and secure the hospital's financial position with impunity but it damages other parts of the local health economy. Who guards the guards?
1:BMJ 2012;344:e3766
Competing interests: Local GP