HSJ live: rolling news 16.1.2013
Commons A&E row fact checked and the rest of today’s news
5pm HSJ has fact checked the claims made by health minister Dan Poulter and shadow health secretary Andy Burnham during a row over accident and emergency waits in the House of Commons yesterday. Mr Burnham claimed the four hour target had been missed in type 1 A&Es on 105 out of the 133 days since Dr Poulter took office. Dr Poulter counter claimed that latest available figures showed 96 per cent of patients had been admitted or treated and discharged within four hours, against the target of 95 per cent.
Analysis of Department of Health weekly A&E performance data found in the 16 weeks (or 112 days) for which data is available since Dr Poulter’s appointment was announced on 4 September the target was met in only three weeks. However, trusts are judged against their quarterly performance and over the third quarter of 2012-13, 95.66 per cent of patients were seen within the target, just within Dr Poulter’s claim of 96 per cent. Dr Poulter may also have seen data for the week ending 13 January which has not yet been published.
Mr Burnham also highlighted figures showing that 15 trusts performance had fallen below 80 per cent in the week ending 6 Jan. He claimed these were “the kind of figures that we have not seen in the NHS since the bad old days of the mid-1990s”. The four hour target was not introduced until 2004 so it is impossible to verify this claim. However, when compared to the same week in 2011-12 there was a three-fold increase in the number of trusts with performance below 80 per cent. In the week including new year’s eve in 2011 just three trusts had performance below 80 per cent.
7.30am Around one million people a day living at home in the UK are currently estimated to be suffering from malnutrition, and these figures do not include those in residential or nursing care. The Food First project has been tackling malnutrition by encouraging good food rather than dietary supplements, offering a better service for elderly residents into the bargain.
“Over the last few years, the medicines management team realised that spending on oral nutritional supplements, which are mainly prescribed by GPs, was increasing steeply, and we were looking for ways to control costs,” says Cathy Forbes, Food First project lead and an advanced specialist dietician.
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matt_black | 16-Jan-2013 6:44 pm
Both the government and some civil servants have never quite got a grip on what is required to drive or sustain A&E performance.
It was obvious to A&E experts, for example, that lowering the target from 98% to 95% would make performance worse because it sent a strong signal to trusts that this was no longer a big focus. Also the focus on quarterly performance encourages gaming and lack of focus on consistently speedy treatment for patients.
Somebody needs to be paying attention to the underlying and unpublished metrics about A&E behaviour as well as the headline numbers. For example, the distribution of waiting times for patients (how many wait 3hrs, how many wait 3hrs 15 mins, how many wait 3hrs 30 mins etc) is a good indicator of the effectiveness of A&E processes (and it clearly shows the difference between last minute rushing and routinely speedy processes). And the civil service needs to learn that the indicators that get published are not always the best ones to use for directing management attention.
The previous government at least understood that how long patients wait for treatment is very important for patients and they spent a lot of time setting (unpopular) targets to drive the performance of the system.
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