Investment in new infrastructure forms part of the latest government measures to cut corridor care and shorten waiting times. The reforms also aim to tackle persistently failing Trusts.
The plans, backed by nearly £450m funding, form part of the move from hospital to community under the Plan for Change. They will deliver around 40 new Same Day Emergency Care and Urgent Treatment Centres to avoid unnecessary admissions to hospital. Up to 15 mental health crisis assessment centres will provide care for patients in a more appropriate setting and avoid them waiting in A&E for hours for care. Almost 500 new ambulances will also be rolled out across the country by March 2026.
NHS Chief Executive Sir Jim Mackey says: “Urgent and emergency care services provide a life-saving first line of defence for patients – but for too long now, despite the incredible hard work of staff, the speed and quality of NHS care has often not been good enough.
“Our patients and staff deserve better, so that is why we need a radical change in approach and to ensure we get the basics right.
“This major plan sets out how we will work together to resuscitate NHS urgent and emergency care, with a focus on getting patients out of corridors, keeping more ambulances on the road, and enabling those ready to leave hospital to do so as soon as possible.”
NHS National Director for Urgent and Emergency Care Sarah-Jane Marsh adds: “This plan sets out not only what we know is working across the country, but how systems must work together to improve access and quality for the benefit of our patients.
“In order to support this shift in delivery focus, NHS England will be asking providers and systems to be accountable to their own local Boards and populations, creating robust winter plans which will be tested during winter exercises throughout September.”
System approach
This new plan sets targets that the government believes are “ambitious but achievable,” and increases transparency about progress. It marks a fundamental shift in the approach to urgent and emergency care – moving from fragmented efforts to genuine collaboration across the whole system and means better coordination between NHS Trusts and primary care to identify patients most vulnerable during winter. It also aims to make the most difference to patients by focusing on specific improvements across the healthcare system, aligning resources to areas that need them most.
As well as the infrastructure investment, the plan includes more paramedic-led care in the community, more patients to be seen by urgent community response teams in their homes and better use of virtual wards. Publishing the controversial league tables on performance aims to drive the promised improvement in transparency and public accountability. It will also encourage less effective systems to work more closely with high performing systems to accelerate improvement.
Providers respond
Chief Executive of NHS Providers Daniel Elkeles says: “There is a lot to like about this plan. It’s helpful that we’re seeing it in early summer, with time to ensure meaningful measures are in place ahead of the added pressures of winter.
It’s also good to see that so many parts of the system, including primary, community and mental health care, in addition to ambulance and hospital services, have been factored in.
The extra capital investment for same day emergency care and mental health crisis assessment centres and ambulance services is particularly welcome.
He adds: “NHS Providers would like to work with NHSE and the government to develop long term UEC plans that are bold and ambitious.”
Association of Ambulances Chief Executives Managing Director Anna Parry says: “By extending and formalising a wider ambulance sector remit in urgent and emergency care, we will be better placed to help resolve some of the key system pressures, reduce the risks for patients and transform patient care while offering a more positive working environment for our people.
“By underscoring the importance of a system-wide focus to achieve improvements in urgent and emergency care, this new plan acts as a genuine challenge to all health and social care leaders, encouraging them to plan and act with purpose to achieve the transformation that is needed. Ambulance service leaders continue to proactively seek increased opportunities for greater collaboration with system partners while identifying new strategies and initiatives within their own ambulance trusts to achieve the transformation targets outlined in the plan.
“We are particularly heartened to see the plan’s emphasis on the reduction and improved management of hospital handover delays. Handover delays have the greatest detrimental impact on ambulance resources and create unnecessary delays and additional harm for thousands of patients each year.”
NHS Confederation Chief Executive Matthew Taylor says: “Health leaders across systems, providers and primary care will welcome this plan to provide better, faster and more appropriate emergency care, an area which is facing high demand and rising public concern over performance.
“As the plan shows, there is a lot of good practice across the health service to build upon, including expanding the number of same day emergency treatment and mental health crisis assessment centres and rolling out more ambulances.
“Making sure the NHS does not continue to fall into crisis each winter will be essential for improving public confidence in the health service. Strong collaboration between health partners and with local government to improve discharges out of hospitals will also be key to progress.”
Every day, more than 140,000 people access urgent and emergency care services across England. Since 2010/11, demand has almost doubled with ambulance service usage rising by 61%.
A&E waiting time standards have not been met for over a decade, while the 18-minute target for category 2 ambulance calls has never been hit outside the pandemic.
At least one in five people who attend A&E don’t need urgent or emergency care, while an even larger number could be better cared for in the community.
