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Woodcock et al1 highlight that changing the 4 h standard from 98% to 95% resulted in processes adjusting accordingly. But they fail to address the key issue of whether it benefits patients. Their conclusion that this shows that more patients are waiting for care is imprecise and possibly wrong. The 4 h standard relates to the total time spent in the emergency department until discharge or admission to a ward. Care starts much earlier; figures for January 2012 show that the median wait for ambulance cases to be assessed by a …
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