HSJ Article – Tackling the Four-Hour A&E Target

Tackling the Four-Hour A&E Target with a whole system approach
A feature created by HSJ in co-operation with Luton & Dunstable University Hospital

Written by Claire Read, HSJ


Reliably meeting the four hour A&E target – under which 95 per cent of patients should be treated, assessed or discharged within four hours of their arrival in the department – is now a year-round worry for many healthcare leaders.

For staff in some emergency departments, it is a goal which has come to be seen as impossible and a source of near-constant demoralisation. After all, England as a whole last hit the target in July 2015.

But at Luton and Dunstable University Hospital Foundation Trust, it is a goal which is not only consistently met: it’s consistently exceeded. In May 2018, the care of 98.4 percent of patients arriving at the A&E department was completed within four hours. It was pretty much the same in May 2017. And the year before that.

So how have they done it? What are the ingredients for their success? And what aspects might others be able to emulate?

Those working in the local clinical commissioning group (CCG) and community provider point to the value of a whole system approach, with as much emphasis on what happens at the back door of the hospital as at the front, and the need for strong communication.

Read the full feature on HSJ or download a copy.

Caroline Capell, Assistant Director of Unplanned Care at Luton CCG, discussed how things work in practice during our recent webinar: “Easing ‘year-round’ winter pressure”. View a recording of the webinar here. 

If you have any questions about the HSJ piece, webinar or how we could help you manage ‘year-round’ winter-pressures, please contact us on 01865 261467 or hello@consultantconnect.org.uk.