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Date: 26 May 2020

Time: 07:43

Time to treatment in A&E

What does this indicator mean?

Time to treatment is the time from arrival at A&E to the time when a patient is seen by a clinical decision-maker who can diagnose the problem, decide the plan for the patient and start or arrange treatment if required.

What is good performance?

The time to treatment should be minimised with patients seen by a clinical decision-maker within 60 minutes (1 hour) of arrival. This may be too long for patients who present with more serious conditions such as stroke, heart attack or breathing difficulties for example.

How is UHB performing?

In May 2015 the average (median) time patients waited from arrival to treatment was 59 minutes. 95% of patients waited 128 minutes (2 hours, 8 minutes) or less. The latest available national performance data shows that the average (median) time patients waited from arrival to treatment was 51 minutes in February 2015.

Graph: A&E clinical quality indicator: time to treatment

What is UHB doing to improve performance?

UHB is working to continuously improve performance for this indicator over time. A review of the pathways for major and minor cases is being undertaken to ensure that all patients are seen by a clinical decision-maker at the most appropriate time.

An additional A&E Consultant started in September 2011 to provide further senior clinical input. Clinicians are continuing to be reminded of the need to record the actual time of treatment in the clinical notes so that performance against this measure is not affected by retrospective data entry of treatment times.

UHB is working to continuously improve performance for this indicator over time. The Trust has implemented a new patient management system called Oceano to ensure that time to treatment is monitored in real time. The Trust is also continuing to invest in additional Consultant and nursing staff over time to ensure patients are clinically prioritised and treated as quickly as possible.

Since January 2015 the streaming process has reduced departmental overcrowding by more appropriately filtered patients into the correct clinical environment. This will have a positive impact on the 60 minute time to treatment.

UHB data quality

Trusts are expected to have less than 5% of patients with a missing treatment time. The Trust’s patient management system ensures that all patients have treatment times recorded.

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