We all have our part to play in delivering the new blueprint for urgent and emergency 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.

Keith Willett

Professor Keith Willett is the Director for Acute Care to NHS England and is the Professor of Orthopaedic Trauma Surgery at the University of Oxford. An NHS consultant surgeon for 24 years he has extensive experience of trauma care, driving service transformation and healthcare management.  He has taught surgery and leadership extensively across the NHS and internationally.

In 2003 he founded the Kadoorie Centre for Critical Care Research and Education focusing on the treatment of critically ill and injured patients. This year IMPS, a children’s safety charity he launched, celebrated 20 years and over 250,000 children trained in risk awareness, first aid and life support.

He was the co-founder of the unique 24-hour consultant-resident Oxford Trauma Service at the John Radcliffe Hospital in Oxford in 1994. Building on that model, in 2009 he was appointed the first National Clinical Director for Trauma Care to the Department of Health and was charged with developing and implementing government policy across the NHS to radically improve the care of older people with fragility hip fractures and to establish Regional Trauma Networks and Major Trauma Centres. By 2012 both re-organisations and care pathways were successfully in place and are now credited with marked improvement in patient care and survival.

In his current role, he has the national medical oversight of acute NHS services ranging from pre-hospital and ambulance services, emergency departments, urgent surgery, acute medicine, children’s and maternity, armed forces, and health and justice services and national major incidents. He is now leading the transformation of the urgent and emergency care services across the NHS in England.

He was awarded a Commander of the Order of the British Empire (CBE) in the New Years Honour’s List in 2016 for services to the NHS.  On receiving this honour he said “I have been exceptionally privileged to build a career as part of the collective commitment of so many dedicated individuals and friends who are our NHS”.