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Bring back the queue



The NHS in England missed its A&E four hour waiting time target in Winter 2013. Just like it did in Winter 2012, 2011, 2010 etc etc. So what? The target was 95% and NHS England scored….. 94.3%. I reiterate. So what?

Many years ago, in the days before waiting time targets were thought of and patients were seen in A&E in order of urgency rather than order of arrival, I wrote a piece in a now defunct newspaper along the lines of: Mum rings GP surgery to inform us that her kid has vomited once and she wants him seen stat. Quite reasonably, Mum is told to obtain what we medics refer to as ‘A life’, take some ‘Man Up’ pills and let us know how things go with Junior over the next few hours.

She wasn’t happy. Eventually, under a good deal of duress we gave the boy an appointment for four hours hence. Which he did not attend. Instead, Mother called us from A&E to tell us that he’d been waiting three hours and hadn’t been seen yet and why can’t we ring the A&E people and tell them to get their expletive deleted fingers out?

She actually moaned to us that she’d have been better off waiting for the appointment we’d offered. Many of us eavesdropping on the speaker phone cried real tears of laughter.

Now the pendulum has swung as far as it can the other way. Patients rock up to A&E with paper cuts and acne and are guaranteed (as near as dammit) some quality time with a doctor within four hours. And we’ve all seen the results. And they’re still not happy.

It’s time to scrap the target, or at least replace it with something sane and workable. ‘If you need to be here, we’ll see you as soon as we possibly can. If you don’t need to be here, you’re in for a bloody long wait. Maybe six to eight hours if we’re busy with stuff that your Mum, your pharmacist, a walk-in centre, a minor injury unit or your GP isn’t better placed to deal with.’

And feel free to clear off and seek advice from any of the above if you don’t fancy a few hours sitting watching sicker people than you are get wheeled past you on gurneys.

There’s only one way we’ll get A&E services to work for the people that really need them. Bring back the queue.

 Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.