The following hospital trusts have worked with the NHS nationally to safely test the urgent and emergency care proposals:
- Cambridge University Hospitals
- Chelsea and Westminster Hospital
- Frimley Health
- Imperial College Healthcare
- Kettering General Hospital
- Luton and Dunstable University Hospital
- Mid Yorkshire Hospitals
- North Tees and Hartlepool
- Nottingham University Hospitals
- Plymouth Hospitals
- Poole Hospital
- Portsmouth Hospitals
- West Suffolk.
The initial testing period explored whether an average (mean) time in A&E could be implemented safely and provide clinicians with a useful measure of activity and patient experience. Upon confirmation that the measure could be introduced successfully with no reported safety concerns, further testing was undertaken to consider:
- measuring time to initial assessment;
- collecting data to examine the feasibility of measuring how fast critically ill or injured patients arriving at A&E receive a package of tests and care developed with clinical experts, and;
- test sites to continue monitoring average (mean) total time in department and long waits from arrival, aiming for continual improvement.
The list of critical conditions included in testing in this phase is: stroke, major trauma, heart attacks (MI – STEMI), acute physiological derangement (including sepsis), and severe asthma.
Neighbouring mental health trusts also tested standards for urgent community mental health services that help prevent avoidable A&E attendances by providing mental health crisis care in more suitable environments where possible. When people do need to attend A&E, the trusts above measure how long people who arrive at A&E experiencing a mental health crisis wait for a psychiatric assessment and, where required, a transfer to appropriate mental health care.
The recommendations from the clinically-led review of NHS access standards for urgent and emergency care, supported by key clinical groups, patient groups and hospital leaders, were set out in the Transformation of urgent and emergency care: models of care and measurement report. Views were sought through a public consultation which ran between 15 December 2020 to 12 February 2021.
The consultation responses are set out in the Clinically-led Review of Urgent and Emergency Care Standards: measuring performance in a transformed system report