NEW A&E waiting time rules could pose a “significant” challenge for Great Western Hospital, executives have heard.

Jim O’Connell, chief operating officer at the Marlborough Road NHS trust, raised concerns about the proposed introduction of new health service rules in autumn.

NHS chiefs suggested in March that a key target – that patients are admitted or discharged within four hours of arriving at A&E – is scrapped. In its place, managers would look at the average time all patients spend in A&E, as well as other targets to see how quickly people were treated.

Speaking to GWH’s board of directors this month, Mr O’Connell warned that in April, the latest month for which figures are available, more than 2,100 A&E patients were left waiting more than four hours for treatment.

A snapshot of 13 patients admitted over two days in May suggested they had spent on average 10 hours waiting on trolleys in A&E – plus a further 14 hours in a GWH medical assessment unit.

“You can absolutely seen the 12 hour breaches have gone up,” said Mr O’Connell.

Now, the question on the lips of NHS bosses was how you measure the amount of time spent in A&E. Currently, the clock can start when a patient is referred to a specialist doctor. That stands to change.

Mr O’Connell said: “They’re moving to say 12 hours really means 12 hours. So, you show up in the emergency department if you’re there 12 hours later that’s a problem.

“Previously, if you’d shown up in ED you might wait for a doctor, then you might wait for a speciality doctor. The 12-hour wait starts ticking for the official breaches when they were seen by a registrar who refers them on to a specialty doctor. They’re saying it’s really camouflaging the crowding problem.

“That’s going to be a significant issue for us, because it’s going to take another three or four years until we’re able to open our new ED and we’ll have our additional 60 beds or so.”

Last year, ministers announced almost £30m for GWH to refurbish its emergency department, with an expanded A&E.

However, it is not expected to open for a number of years. In the meantime, hospital executives are developing a plan of how to reduce pressure on the A&E, Mr O’Connell said.

Four hour target missed

GREAT Western Hospital missed a key four hour A&E target in April.

NHS bosses say every hospital should aim to admit or discharge at least 95 per cent of patients within four hours of their arrival through the doors of the emergency department.

In Swindon in April, the latest month for which figures are available, 81 per cent of patients were seen within four hours - four points below the England average of 81 per cent.

Chief operating officer Jim O'Connell said: "The teams really have been under the same kind of pressure over the last couple of months that they would have been at the height of winter." Nerissa Vaughan, GWH's chief executive, said the hospital was experiencing "unprecedented demand".