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The National Emergency Access Target (NEAT): can quality go with timeliness?

Increasing demand on health services during times of austerity has necessitated examination of the way we deliver health care.1,2 In 2008, Western Australian tertiary hospital emergency departments (EDs) were experiencing the highest rates of access block (the percentage of patients who wait longer than 8 hours for an inpatient bed) in the country.3,4 The well documented relationship between access block and poor health outcomes for patients,59 coupled with adverse media and public opinion about Western Australia’s public hospitals, demanded a significant response. A Minister for Health delegation travelled to the United Kingdom to examine National Health Service (NHS) reforms,10,11 to learn from their successes to improve health care delivery in WA. Subsequently, in April 2009, the Four Hour Rule (FHR) Program was launched in WA.12 Stage 1 of the program involved the state’s…