Intended for healthcare professionals

Letters Four hour target

Improving services requires resources not targets

BMJ 2019; 364 doi: (Published 22 February 2019) Cite this as: BMJ 2019;364:l830
  1. Peter J Campbell, independent public health consultant
  1. Heidelberg 69120, Germany
  1. peterinwork{at}

Simon Stevens proposes that emergency departments focus waiting time targets on a few specific conditions.1 But few people enter emergency departments with a diagnosis of sepsis, myocardial infarction, or stroke. Instead, they present with fever, pain radiating down the arm, or numbness. How do we know for whom the “clock should start”? …

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