Intended for healthcare professionals

Letters Four hour A&E target

Four hour target prioritises the comparatively well

BMJ 2019; 365 doi: (Published 08 April 2019) Cite this as: BMJ 2019;365:l1615
  1. Simon Ashworth, consultant and head of speciality
  1. Critical Care, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London W2 1NY, UK
  1. simon.ashworth1{at}

Whatever the merits of the four hour target for patients attending emergency departments—and these objectively seem to be confined to convenience—it has had a distorting effect on the management of patients.1234 It causes beds to be allocated to emergency patients over those being de-escalated from intensive care; this causes delays in admission to the intensive care unit, which is harmful. Lack of …

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