Achieving the new accident and emergency clinical quality indicators will be “near impossible” for most trusts, the Foundation Trust Network has warned.

Implemented last Friday when the 2011-12 operating framework came into force, the eight indicators are designed to replace the four hour A&E target.

The category B ambulance target for serious but non-life- threatening calls has also been replaced, with 11 indicators.

Monitor has postponed the indicators’ introduction to its compliance regime until July to give foundation trusts time to set up data collection systems.

Network director Sue Slipman said: “[When] the 98 per cent A&E target was first introduced there was sufficient lead-in time to make proper investment in achieving it. Now, with the introduction of the outcome measures, trusts have been given three months, making it a near impossible task.”

She said no organisation in a recent network study was able to achieve all of the indicators.

Five of the  indicators have been included in the operating framework (see table below). Foundation trusts failing on three or more indicators for three quarters will have a weighting of 1 added to their governance risk rating. Those failing on two will have a weighting of 0.5 added.

A Monitor spokesman said persistently failing on three or more indicators could trigger intervention but stressed it would not be “automatic”.  National clinical director for urgent and emergency care Matthew Cooke said missing an indicator would be a “trigger for an explanation”.


The five A&E indicators in the operating framework

Unplanned re-attendance at A&E within 7 days
Between 1 per cent and 5 per cent
Total time in A&E
95 per cent of patients should be seen within four hours; maximum wait six hours.
Time from arrival to start of full initial assessment
All patients assessed within 20 minutes;  95 per cent within 15 minutes
Time to treatment from a decision-making clinician
A median of 60 minutes
Percentage of people who leave the A&E department without being seen
Below  5 per cent