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Analysis of the distribution of time that patients spend in emergency departments

BMJ 2005; 330 doi: (Published 19 May 2005) Cite this as: BMJ 2005;330:1188
  1. Thomas E Locker (, research fellow in emergency medicine1,
  2. Suzanne M Mason, clinical senior lecturer in emergency medicine1
  1. 1Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield S1 4DA
  1. Correspondence to: T Locker
  • Accepted 22 March 2005


The NHS Plan stated: “By 2004 no one should be waiting more than four hours in Accident and Emergency from arrival to admission, transfer or discharge.”1 This target was changed to allow for certain clinical exceptions, and since January 2005, 98% of patients must spend less than four hours there.2 We analysed the distribution of time spent by patients in emergency departments in England.

Participants, methods, and results

We invited major emergency departments (those providing 24 hour cover and most core services) in England to submit data for each new patient attending during April 2004. We determined the distribution of total time in each department for patients who were admitted to hospital and for those discharged from the department. To assess the generalisability of these findings, we used performance data from the Department of Health to compare trusts in which at least one department had submitted data or in which no department had.3

We received data from 83 …

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