Emergency target halved

The target for reducing emergency bed days has been cut in half.

The publication of this week's public service agreements for the DoH, published as part of chancellor Gordon Brown's comprehensive spending review, set a target of cutting emergency bed days by just 5 per cent by 2008.

However, a final draft copy of the Treasury's PSA documents, seen by HSJ just over a month ago (news, pages 3-5, June 10), revealed that the target for reducing bed days would be 10 per cent by 2008.

Health service figures told HSJ last month that the 10 per cent figure should be achievable, and there was surprise that the target had been reduced at the last minute.

One senior DoH source suggested the figure could have been changed because of fears that any larger reduction in emergency bed days would not have been sustainable across the country. Therefore a lower figure was set to ensure that the target could be hit nationwide.

NHS Confederation policy director Nigel Edwards argued 5 per cent would be achievable simply by improving internal management of accident and emergency departments and early rehabilitation.

South Yorkshire strategic health authority chief executive Mike Farrar suggested that the ambitious 18 week 'journey time' target may have meant concessions elsewhere in the service.

NHS Alliance chair Dr Michael Dixon said the lower central target would 'loosen up the system', and make it easier for local targets to be set around improving chronic-disease management.

Greater use of local targets was also made more likely by the announcement that a 40 per cent reduction in health inequalities around heart disease and strokerelated diseases, must be achieved by 2008. Inequalities on cancer levels must also be cut by 6 per cent and smoking rates among 'manual' groups reduced to below 21 per cent.

Mr Edwards said: 'One-size-fitsall targets do not actually apply to this kind of goal.'

A huge increase in the Sure Start programme was also announced this week, with a pledge to devote an extra£769m to care of disadvantaged children by 2007-08 compared to this financial year. It will provide 2,500 children's centres by 2008.

The Department for Education and Skills and the DoH also have a joint target to halve the under-18 conception rate by 2010.