WIREDGOV

The first of a series of new patient-focused health targets, for A&E and the ambulance service, will be developed from April, Health Minister Mark Drakeford announced yesterday

These new measures – the first to focus on the clinical results patients receive from treatment – will be developed alongside traditional NHS targets, which focus solely on the time it takes for patients to receive treatment.

Clinicians have expressed concern about the way the current NHS targets are insufficiently focused on patient outcomes and may lead to a drive to achieve targets which are not necessarily designed around the best interests of all patients.

The current category A eight-minute response time ambulance target was created 40 years ago. Clinical studies have shown that for most emergencies, an eight-minute response makes no discernible difference to a patient’s outcome.

However, there is a direct correlation between the speed of the emergency response and a patient’s chance of survival for a few life-threatening conditions – for example cardiac arrest and stroke.

The new developmental, patient-focused targets will capture the combined emergency response from the time of the 999 call to the start of effective clinical treatment. For patients who have suffered a heart attack, this may be when they are given clot-busting drugs by the trained paramedics before they get to hospital.

New targets will also measure the pre-hospital care patients who have suffered a stroke or a fractured hip receive when they dial 999.
In A&E, the existing target places a greater emphasis on time than on what care a patient receives in the department - 95% of patients are required to be seen and their treatment finished within four hours.

The new measures will involve a trial of a scheme based on clinical priority and another of a scheme based on waiting times from arrival to time of treatment started.

Welsh Government Health Minister Mark Drakeford said:

“I want us to judge the success of our services by measuring things which make a difference to patients and the effectiveness of the treatment they receive.

“This development work will make sure what we measure is more meaningful in terms of clinical benefit and outcomes for patients, rather than on the basis of time alone.

“As the McLelland review made clear, the eight-minute ambulance target is in many ways an arbitrary figure rather than being based on patient or clinical evidence.

“We will be sharing the results of the development work widely and will be holding public discussions on the findings before making any decisions about future measures.”

The new measures are in the developmental phase – 2014-15 will be a transition year when they will run alongside the current NHS targets which will allow enable performance to be monitored against existing measures. New measures for cancer and planned care are also being developed for introduction later this year.

The Welsh Government’s clinical lead for improvement in unscheduled care, Dr Grant Robinson added:

“We will be working with clinicians to develop measures of urgent and emergency care which make sense to people using these services and which give a clearer sense of quality of care.  

“Like other measures of safety and quality in Wales, we will make these transparently available to allow people to see easily how their local health service is doing.”