The four hour target was both the best thing to happen to Emergency Medicine and the worst thing to happen to Emergency Medicine in the UK.
The priority that it gave to emergency care and the increase in resources associated with this improved the quality of care out of all recognition compared to previous practice. The perverse incentives created by the target and the inappropriate solutions imposed by some managers or so called experts have undoubtedly compromised the care of some patients. I have worked in Emergency Departments in Australia where this target does not exist and overall things are better in the UK (IMHO).
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