Urgent and emergency care capital incentive scheme

Classification: Official-Sensitive
Publication reference: PRN01225

To

  • Integrated care boards:
    • chairs
    • chief executives
    • chief operating officers
    • medical directors
    • chief nurses/directors of nursing
  • NHS acute trusts:
    • chairs
    • chief executives
    • chief operating officers
    • medical directors
    • chief nurses/directors of nursing
  • Regional directors

Dear colleagues,

We recently met with ICB and acute trust leaders to discuss how we best work together to meet the challenge of delivering the agreed target of 76% A&E 4-hour performance during March 2024 so that more patients are seen, treated and discharged in a timely way.

At this meeting, we referred to an expansion of the UEC capital incentive scheme that trusts can access for 24/25, and this note sets out the detail of how this will be taken forward to ensure that more organisations are rewarded for the improvements they are able to make to the timeliness of patient care, and are therefore able to further invest in their infrastructure.

The original capital incentive scheme offered any trust meeting two criteria the opportunity to access additional capital funding in 2024/25. The two criteria are:

  • 4-hour performance >80% across the final quarter of 2023/24
  • 90% of ambulance handovers to completed within 30 minutes across the second half of 2023/24

Several organisations are already on track to be eligible to receive additional capital based on their performance throughout the course of 2023/24 and the funding to do this is secured.

In addition we are now announcing three other routes through which trusts will be eligible for additional capital funding in 2024/25:

  1. The 10 trusts delivering the highest level of 4-hour performance during March will each receive £2 million.
  2. The 10 trusts who deliver the greatest percentage point improvement in March (compared to January 2024 performance) will each receive £2 million.
  3. The next 10 trusts who deliver the greatest percentage point improvement in March (compared to January 2024 performance) would each receive £1 million.

These will be based on the trust footprint data, attributing the attendances of the nearby
type 3s to the relevant local type 1 A&E service to create a better ‘like-with-like’ comparison between major A&E providers.[1]

Trusts who have already qualified for capital through the original incentive scheme will not be eligible to receive further funding through these additional mechanisms. However, it would be possible for a single trust to qualify for a maximum of two of the three capital awards above (that is, to be both one of the best performers nationally having achieved this through the greatest performance improvement), meaning the maximum award could be £4 million.

It has been a difficult year across the NHS as systems have balanced the need to recover UEC, elective and primary care services for the benefit of patients who rely on timely access to high quality care, within the constraints of a challenging financial landscape, increased demand and the impact of industrial action. We would once again like to thank colleagues for their efforts in facing into these challenges, and the focus that we know you are all putting on landing the financial year in as strong a position as possible.

Yours sincerely,

Sarah-Jane Marsh, National Director of Integrated Urgent and Emergency Care and Deputy Chief Operating Officer, NHS England.

Julian Kelly, Deputy Chief Executive and Chief Financial Officer, NHS England.

[1] The attribution is either as agreed at local A&E delivery board level or is based on using SUS to split type 3 provider activity to relevant type 1 providers. The acute trust footprint data can be found on the last tab of each monthly publication file (Statistics » A&E Attendances and Emergency Admissions 2023-24 (england.nhs.uk)), and no change is required in how data are submitted for the monthly publication.