A&E failing to meet its waiting time targets

Under national measures, the hospital is supposed to admit or treat and discharge 95 per cent of patients within the four-hour time limit.

But Doncaster and Bassetlaw NHS Foundation Trust (DBHFT) has failed to meet this target in October, November and December at its A&E service departments.

The trust has A&E departments at Bassetlaw Hospital, Doncaster Royal Infirmary (DRI) and a nurse-led minor injuries unit at Montagu Hospital. A report, which went before the trust’s board of governors on Tuesday, set out an action plan to improve the situation.

Richard Mitchell, chief operating officer, told the meeting that when the three sites were combined, the DBHFT service is ranked as being between the 18th and 25th busiest A&E department service in the country.

From April to September last year, he said, the combined sites were reaching the 95 per cent target but the situation had since ‘deteriorated’.

Mr Mitchell said the trust had seen an increase in the number of people coming through its doors, but evidence suggests that a number of these do not require ‘acute intervention’.

An audit over the last few months at DRI found that many patients attending could have been treated more appropriately in the community. These patients had long-standing conditions, chest infections, dental conditions, conjunctivitis and old injuries. Of these patients, 70 per cent were either unable to get an appointment with their GP or got an appointment but chose to attend A&E instead.

Mr Mitchell said that across the country health trusts were struggling to meet the four-hour target. In December the DBHFT was given £801,000 to support the delivery of care over the winter months and health chiefs devised a plan to help the trust meet its target.

It includes making cultural and behavioural changes, for example the average time it takes for a patient to be seen in the department or for a decision to be made.

Changes will also be made outside the department to improve performance, including ensuring access to beds at the right time of day so patients can be admitted to wards within the time frame and improving services outside A&E so people are not attending the department when they could be seen elsewhere.

In his report, Mr Mitchell concluded: “The trust and its executive team are committed to marking sustainable, long term improvements to A&E performance. It must be noted that this is against a backdrop of nationwide poor A&E performance and variable performance at DBHFT for a number of years.”

“Some of the actions will take a number of months to come to fruition and short term intensive measures are also being activated to improve performance.”