Urgent and emergency care

Sustaining urgent and emergency care performance has been very challenging since the start of the pandemic. We know that a long term improvement approach is needed for the full recovery of urgent and emergency care services.

We are transforming community and urgent and emergency care services to make sure we deliver safe, high quality care. These reforms will prevent inappropriate attendance at emergency departments, make sure that they stay only as long as they need to and help to restore ambulance response and handover times to pre-pandemic levels.

How we’re making a difference

What are we doing?

In 2022/23 our priorities are:

Reducing waits

We need to reduce 12 hour waits in emergency departments towards zero, and no more than 2%.

Improving ambulance response and handovers

We are developing plans to improve all Ambulance Response Standards to achieve Category 1 and Category 2 mean and 90^th percentile standards, meaning that the most urgent patients will be responded to more quickly.

We are also working to minimise handover delays between ambulance and hospital, allowing ambulance crews to get back on the road more quickly. This includes:

Eliminating handover delays of over 60 minutes.
Making sure 95% of handovers take place within 30 minutes.
Making sure 65% of handovers take place within 15 minutes.

Improving NHS 111

We are increasing capacity within NHS 111 to make sure the service is the credible first option for patients, enabling their referral to the most appropriate care setting. This work includes:

Increasing call handling capacity to meet growing demand.
Increasing clinical capacity within the clinical assessment service to support decision making, with more calls having clinical input.
Making sure there is a full range of available onward referral options in the Directory of Services to meet local need.
Adopting new regional and national route calling technology.

Urgent Treatment Centres

We are expanding urgent treatment centre (UTC) provision across South West London and moving to a model where UTCs act as the front door of emergency departments. This will allow emergency medicine specialists to focus on higher acuity need within emergency departments.

Improving children and young people’s services

Put in place integrated health and care plans for children and young people’s services that include a focus on urgent care. This work includes:

Building on learning from pilot schemes placing paediatric staff within NHS 111 services.
Developing better connections between paediatric health services across the system.
Joining up children’s services across the NHS and local authorities.
Improving transitions between children’s and adult services
Supporting young people with physical and mental health needs within acute and urgent care settings.

Urgent community response

In 2021/22 we launched the two hour community response services across South West London. These services run from 8am to 8pm seven days a week, with services in Croydon and Sutton offering 24 hour care. The services are able to see patients rapidly within their usual place of residence with the aim to prevent hospital admission. A wide range of services is offered, including but not limited to falls pick-up, urgent catheter care and support in case of unpaid carer breakdown. Find out more about how we are developing our urgent community response services.

Learning from data

We will consistently submit timely Emergency Care Data Sets (ECDS) seven days a week. ECDS collects information about why people attend emergency departments and the treatment they receive, which allows the NHS to improve patient care and plan services more effectively.