Patients admitted to meet targets at cost of £2 billion

According to today's Times, targets intended to cut waiting times for A&E have had the effect of causing two million extra hospital admissions over the past five years at a potential cost to the NHS of up to £2 billion.

The extra cost comes because patients who are in danger of having to wait more than the target time of four hours have been admitted to hospital "just in case".

The figure of two million extra admissions in England comes from research by the CHKS group, an independent provider of healthcare information. However, there has been no corresponding increase in admissions in Scotland or Wales, where the four-hour target does not apply.

Whenever you set a target or an incentive, it is important to think through what behaviour it is likely to encourage, and whether this is the behaviour that you want. It would appear that this had not been done in the case of the four-hour target.