Wednesday, 26 March 2014

What's a target, anyway ?

A&E targets missed Again - Echo 25th March 2014

In archery, a target is a series of increasingly smaller, coloured rings on a circular background approx. 1.1/2 m square.  The object is to fire arrows at it with the aim of getting as close to the centre ring as possible ( Preferably not on a public avenue ). Of course, the first factor in this process is the distance between the target and the archers.  If they are at opposite ends of a 40 acre field the target is probably out of sight and out of reach.

The second factor is in having a bow of sufficient strength to propel an arrow all the way to the target and to penetrate the rings.

This analogy may seem inappropriate for a public health service but it does serve to make some useful parallels.  The first one is the question, “Who sets the target and what benchmarks are used to determine if they are attainable”.  With the NHS, this is the target for A&E which is set by some politically - guided bureaucrat who has absolutely no idea what is achievable because two factors not available. The first is; the resources available to deal with healthcare needs of the second factor which is, “How many people will need treatment over the target period ?” Quite simply, how do you know how many A&E resources are needed when you have absolutely no idea of the anticipated number of patients – let alone how to meet their needs?

The third factor is whether or not the archer has the expertise to aim at the desired target, or whether the A&E consultants are able to control any kind of aim that enables him to hit the target.  Finally, what penalties do you impose if A&E staff fail to meet the target that they did not agree this objective as being feasible in the first place ?

The same argument applies to all specialties within the NHS, especially the Ambulance Trust to whom targets are , quite simply, ridiculous and utterly meaningless when they have no idea how many patients they will have to transport, over what mileage, in any one day, let alone a year.

In conclusion it would appear that setting targets in the NHS is impossible, and the idea is as useless as udders on a bull !    R. W.

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