Published: 16/01/2003, Volume II3, No. 5838 Page 4 5

One in three trusts failed to meet last April's accident and emergency target of ensuring that 75 per cent of patients wait less than four hours, an analysis of Department of Health figures has revealed.

And experts have warned that the target for 90 per cent of patients to be admitted, transferred or discharged within four hours by the end of March is unlikely to be met.

DoH figures show how the government treats A&E waiting targets differently to those for inpatients.

While every acute trust is judged individually on whether it meets inpatient waiting targets, A&E performance has been measured on a nationally aggregated basis.

Last month, NHS chief executive Nigel Crisp's end-of-year report said that, overall, 77 per cent of patients were waiting less than four hours in A&E from July to September. His April report had showed the 75 per cent figure had just been achieved.

But detailed DoH figures for A&E waits between July and September 2002 reveal a sharp 'postcode variation', with onethird of trusts missing the 75 per cent target.

Though several trusts had dealt with 90 per cent or more of A&E patients within four hours, 10 trusts had dealt with 60 per cent or less in this time. The 10 were:

Aintree Hospitals trust, Basildon and Thurrock General Hospitals trust, Brighton and Sussex University Hospitals trust, Dartford and Gravesham trust, Guy's and St Thomas' Hospital trust, Kingston Hospital trust, Newham Healthcare trust, North Staffordshire Hospital trust, Royal United Hospital Bath trust, Whipps Cross University Hospitals trust.

British Association for A&E Medicine president Dr John Heyworth told HSJ that figures were 'probably an underestimate' of the number of trusts failing to meet the 75 per cent target because they were compiled before last week's tighter guidance was issued, on how waits should be counted.

And he warned that the 90 per cent target was 'not going to be met in the timescale [the government] wants' despite 'a lot of activity' by A&E departments.

A&E consultant Dr Matthew Cooke, a DoH advisor, said: 'Not every trust will be at 90 per cent by March, ' while emergency access 'czar' Professor Sir George Alberti said the 90 per cent target was 'very challenging considering the facilities we have and the staffing'.