FTs must still report against relaxed A&E indicators

Under Monitor’s original Compliance Framework released in March, FTs were to be penalised for poor performance against the five core indicators from 1 July onwards. However, the indicators were removed from the framework due to concerns about data quality.

Evidence is mounting that many trusts are struggling to capture accurate data, with some finding the additional workload a burden. At the start of August, the regulator wrote to foundation trusts informing them it would only be monitoring compliance with the four hour A&E standard, which the indicators were designed to replace.

The change follows the Department of Health’s decision to relax performance management against the indicators and focus on the four hour target - a flagship indicator of the former Labour administration - in June.

One foundation trust manager told HSJ the effort required to deal with the extra data requirements had been “extraordinary” and had diverted staff from other duties.

Meanwhile, a report to the board of South Devon Healthcare Foundation Trust said it had to take on “additional coding resource” to deal with the “backlog”.

The indicators measure time to initial assessment for patients arriving by ambulance, time to treatment and total time in A&E, as well as the percentage of patients who leave without being seen or have an unplanned reattendance within seven days.

In its monthly bulletin due to go out to trusts tomorrow, Monitor will remind foundation trusts it is still a requirement for them to report performance against all five indicators to the NHS Information Centre under the terms of their authorisation.  

President of the College of Emergency Medicine John Heyworth told HSJ collecting the necessary data was “labour intensive” and a “significant proportion” of trusts were still having trouble with it. However, he said emergency departments which had good IT had been able to adapt “without too much difficulty”.

Dr Heyworth, who worked with the DH on developing the indicators, described Monitor’s decision to remove the indicators from the compliance framework was “pragmatic” during the period of transition. But he warned that trusts should not expect more than a couple of quarters to put in place the data systems and improve performance against all measures.

In the bulletin Monitor encourages foundation trusts to report performance on their website and promises to consult trusts on future changes to scoring of the indicators in the compliance framework. The governance score for trusts failing to meet the A&E standard has been doubled to one.