comment: But watch out! A&E departments have few laurels on which to rest

Published: 16/01/2003, Volume II3, No. 5838 Page 17

Managers can take heart from the absence of traditional winter crisis-mongering by the media. Whether the credit must go to good planning or low levels of flu infection, accident and emergency directors seem cautiously content that admission levels have so far been largely containable. There are a difficult few weeks ahead, but even where admissions are rising the evidence seems to be that faster discharges are enabling departments to cope.

So bad news for journalists relying on the 'winter crisis' story to provide a UK element to a news agenda dominated by foreign affairs, but an encouraging start to a tough year in the NHS. However, it is clear that many A&E departments have few laurels on which to rest (news focus, pages 10-12). They have just 10 more weeks to meet the target of 90 per cent of patients waiting no longer than four hours for admission, transfer or discharge - and the DoH's A&E advisor is certain that not all trusts will make the grade.

The British Association of A&E Medicine is already pleading - surely in vain - that fingers should not be pointed at failing departments. Appearing to struggle on this very high-profile target - and as we point out, there has been little detail from the centre on current performance - is a worrying sign. Suggestions of 'gaming', 'fiddling' and, more kindly, 'woolliness' over how waiting times are recorded only add to concerns.

In the coming weeks HSJ will be looking at some of the other major target areas, likely progress so far, and the implications of failure. Although the winter crisis may not have materialised, it will be a long march until spring.