Health Secretary Directs NHS Leaders to Prioritize Patient Safety Over A&E Target Amid Winter Pressures

Wes Streeting, the Health Secretary, has instructed health leaders across England to give precedence to patient safety, acknowledging that this may lead to a decline in performance against the four-hour A&E waiting time target during the upcoming winter period. This directive was issued during a meeting held in London on Monday, attended by hospital executives and other NHS officials, amidst increasing apprehension regarding the escalating winter demands. Data released last week indicated that hospitals were already experiencing considerable strain for this point in the winter season, characterized by prolonged ambulance queues outside Accident & Emergency departments and 95% occupancy of hospital beds. According to government sources, the Health Secretary’s intention was to offer “reassurance” to the NHS, ensuring that it would not face penalties should performance against the aforementioned target decline. These sources clarified that this guidance does not signify the abandonment of the target, but rather emphasizes that patients must be prioritized based on “clinical need.” Streeting stated, “We have to be realistic about what can be achieved in the coming months.” Furthermore, NHS leaders were instructed to undertake all possible measures to mitigate ambulance delays during patient handovers at hospitals; by the start of December, two-thirds of crews were encountering extended waits, impeding their capacity to respond to 999 calls. Achieving the target necessitates the NHS attending to 95% of patients within four hours of their arrival. However, figures for October indicate that only 73% of patients were seen within this timeframe. Following the meeting, which saw the participation of 700 health leaders both physically and virtually, Streeting commented: “We inherited a broken NHS that saw annual winter crisis as the norm. This year, we’re seeing record pressures on services as we move into December.” He added, “I want to see patient safety prioritised as we brace ourselves for the coming months. I’m asking trusts to focus on ambulance delays, handovers and the longest A&E waits.” Amanda Pritchard, NHS England chief executive and host of the gathering, stated that the health service is confronting “unprecedented demand” as winter approaches. She further elaborated: “Patient safety must be paramount and speaking to local leaders today, the message was clear: we need every part of the NHS and social care partners, working together to manage demand and ensure patients with the most urgent needs are prioritised.” Dr. Tim Cooksley, representing the Society for Acute Medicine, expressed that it was “concerning” that the Health Secretary deemed it necessary to articulate the priorities for frontline staff. He asserted: “The stark reality is not that hospitals and staff on the frontline are manipulating targets, but that they are simply unable to deliver safe care even when trying their utmost to do so given the impossible situations they are in.” Dr. Cooksley further criticized the government, alleging a lack of a cohesive strategy to address the strains within the emergency care system. He highlighted that the government has designated the 18-week target for non-urgent care as a primary objective for this parliamentary term, yet has not extended the same commitment to the four-hour A&E target. While in opposition last year, the Labour party stated its intention to achieve all principal NHS performance targets, including those for A&E. However, this pledge was not included in their manifesto and has not been reiterated since the election, with ministers now indicating they cannot guarantee that the four-hour target will be met.