Senior doctors and Scotland’s health secretary are reaffirming their commitment to keeping accident & emergency targets for the health service north of the border.

Royal colleges in Scotland say the standard – to see, admit, transfer or discharge 95% of patients in four hours – is a patient safety indicator because it shows whether the whole hospital is functioning well.

It comes after suggestions the target could be scrapped for the health service in England.

Scottish health secretary Jeane Freeman told MSPs: “We will continue to work towards that target [and] we will continue to be the best-performing NHS in the UK”.

Recent figures show emergency departments in Scotland saw 86% of patients in four hours over November. Nearly 1,000 people faced waits of more than 12 hours.

Although the target has not been met since July 2017, doctors’ leaders have told healthandcare.scot it should be kept.  

David Chung, vice president of the Royal College of Emergency Medicine and an emergency medicine consultant at Crosshouse hospital, said in an interview “the target shouldn’t be an end itself – it should function as the canary in the coal mine.  

“It is essential because it is a safety marker, a safety indicator,” he explained.

“There has been increasing work that would indicate if your system is allowing people to spend a long time in the emergency department the system is too overloaded and is harmful to patients.”

“From the evidence base we’ve got so far in the world when you have lots of eight hour waits and certainly when you have lots of 12 hour waits you are going to have some avoidable morbidity and mortality whether you like it or not.”

Derek Bell, president of the Royal College of Physicians of Edinburgh, the target is also about avoiding treatment delays than can lead to patient harm: 

“The A&E waiting time targets are important as they help to identify the level of pressure NHS services are under – not just emergency departments.

“This of course has implications for patients. Long waits at emergency departments can be distressing for patients and in some serious cases, delays of treatment are unsafe and can have a knock-on impact on other healthcare services.

“The College does not advocate a move towards scrapping performance targets like in England, where the UK Government is considering a move away from 4-hour A&E targets. Doctors in England have already expressed the view that such decisions must be patient orientated and not politically driven”.