Observing the NHS’s A&E performance objectives: is lean the cure?

Abstract

Purpose

The purpose of this paper is to investigate England’s Accident and Emergency (A&E) portion of the National Health Service (NHS). This paper is based upon weekly published data from A&E trusts across England, spanning from November 2010 to December 2014.

Design/methodology/approach

Emphasis is placed on a number of variables; month (time of year), performance (patients seen in less than four hours), patient volume and exploring the relationship between these variables. A deductive approach has been selected as the most appropriate for this paper and the format of a correlational study. Lean will be discussed as a philosophy throughout this paper, as a means to improve the NHS.

Findings

The NHS’s success in reaching its 95 per cent performance objective has in a gradual downwards trend since the data started being published and the volume of patients seen in A&E is trending upwards. However, there is only a weak relationship between these variables, suggesting that peak in demand are effectively foretasted by the NHS and appropriate resources deployed to combat this. Additionally, there is a clear relationship between the time of year (month) and volume.

Research limitations/implications

The data used are not broken down and are aggregated from A&E departments across the NHS in England. Therefore, outliers could be present that impact the data and results. Should outliers exist, these should be targeted for improvement or to be learnt from, depending on their ranking.

Practical implications

Should the NHS continue with their Lean transformation, it is believed that efficiency will improvement throughout the organisation.

Social implications

Through the identification of volume trends better care and efficiency can be provided to patients visiting the A&E departments of the NHS.

Originality/value

This paper analyses data over the past four years which can be used to spot past trends and predict future trends, therefore smoothing the reliability and quality of the care offered to patients. This can be achieved through a Lean transformation and a flexible resourcing approach.

Citation

Bancroft, J. and Saha, K. (2016), "Observing the NHS’s A&E performance objectives: is lean the cure?", International Journal of Quality & Reliability Management, Vol. 33 No. 8, pp. 1099-1123. https://doi.org/10.1108/IJQRM-02-2015-0016