The Audit Commission examined A&E services in 1998 as part of its programme of following up previous value-for-money work and found that waiting times had lengthened in many departments. This was despite reduced growth in the numbers of patients attending A&E departments. Given these concerns, A&E services were included for further review in 2000 as part of the Audit Commission's Acute Hospital Portfolio.
The data were collected in July 2000 and almost all NHS trusts that provide A&E services in England and Wales took part. Auditors then used the comparative data this generated to produce a tailored performance assessment for each trust to identify what, if any, further work was needed. This review reports the national findings from the comparative data, taking into account any amendments that have resulted from discussions with individual trusts.
The demands placed on A&E departments are inherently unpredictable and varied, and as a result they are difficult to match. A balance has to be struck between providing resources sufficient to minimise patients' waiting times and maintain good-quality care on the one hand, and avoiding overcapacity and underoccupied staff on the other. It is important to assess performance in A&E departments in the context of this balance. This review addresses four objectives of any A&E department:
- waiting times - minimising the time patients have to wait for treatment in the department
- staff - making efficient and effective use of staff
- quality - delivering a high-quality service
- information - having good management information