We have recently demonstrated that the distribution of total time spent by patients in emergency departments (EDs) in England shows a peak immediately prior to the current Department of Health target of 4 hours. We aimed to investigate whether this suggested that performance data were being manipulated. We collected data from 117 EDs, and 616 067 patient episodes were included in the analysis. Evidence of manipulation of performance data appears to be present in a small proportion of episodes, but because of the numbers involved, it could equate to over 50 000 episodes per year in EDs in England.
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This study was conducted as part of a study funded by the National Co-ordinating Centre for NHS Service Delivery and Organisation Research and Development. The funding body was not involved in the design or analysis or in the decision to publish this study.
Competing interests: there are no competing interests.
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