By Professor Keith Willett, NHS England’s Director for Acute Episodes of Care.
You will have all seen Sir Bruce Keogh talk about the recent publication of NHS England’s Urgent and Emergency Care Review End of Phase 1 report. I have led the Review for Sir Bruce and the publication of our report sets out a vision for how we can deliver a new system of urgent and emergency care.
Our vision is simple:
- Firstly, for those people with urgent but non-life threatening needs we must provide highly responsive, effective and personalised services outside of hospital – as close to people’s homes as possible, minimising disruption and inconvenience for patients and their families.
- Secondly, for those people with more serious or life threatening emergency needs we should ensure they are treated in centres with the very best expertise and facilities in order to maximise their chances of survival and a good recovery.
In our report we also set out how we intended to deliver on this vision, by:
- Providing better support for people to self-care
- Helping people with urgent care needs to get the right advice in the right place, first time
- Providing highly responsive urgent care services outside of hospital
- Ensuring that those people with serious and life threatening emergency care needs receive treatment in centres with the right facilities and expertise, and
- Connecting all urgent and emergency care services together into a cohesive network so the overall system becomes more than just the sum of its parts.
As a consultant trauma surgeon for over 20 years I have seen and experienced the contribution that a safe, efficient, and strong urgent and emergency care system makes to all our lives, and those of our friends and family. That’s what we are trying to enhance and sustain in this Review.
What we propose is the greatest change to emergency services in 40 years; it will change the way patients access care and how efficiently they are treated. But we know that a considerable amount of innovative work is already going on, very much in keeping with the aims and spirit of this Review. We intend to capitalise on this, and spread its adoption. I strongly believe that this Review will be a success if, by building it in public with extensive discussion, no-one is surprised by the outcome because the changes we propose have already been adopted.
As the Delivery phase of the Review begins, and the reforms we proposed begin to filter through our system, the key to their success will be you, those who work in the NHS: the staff in the ED, the paramedic on the road and our doctors and nurses in the community and in our hospitals. Our timescale for the Delivery phase of the Review is three to five years.
As winter approaches the stresses that the current system is under are brought into sharp focus. We started preparing for winter earlier than ever this year, to try to learn from the lessons of the recent past, but we don’t underestimate the challenges that the season poses.
Many people associate winter with being the busiest time of the year for A&E attendances but, in fact, attendances during the summer are traditionally higher. The real challenge for A&E at this time of the year is coping with number of people who subsequently require admission.
These issues are at the heart of the Review – we need to strengthen the delivery of urgent and emergency care across the whole system to help people get the care they need much earlier than is the case at present, and much closer to home, so that we can try to tackle the causes of this problem as opposed to the symptoms.
We are rightfully very proud of our healthcare system and we know how hard the vast majority of NHS staff work every day to keep a huge, complicated and extremely well-respected health service working. Now we want to shape and protect it and make sure it serves the important people – our patients for the future.