Integrated urgent and emergency care

Delivering improvement across integrated urgent and emergency care pathways

The joint NHS and Department of Health and Social Care (DHSC) Delivery Plan for Recovering Urgent and Emergency Care Services sets out the first steps in transforming urgent and emergency care.

The plan includes two key ambitions for the next two years – a 30-minute mean response time for Category 2 ambulance and 76% performance in A&E wait times, measured through the 4-hour target.

Our ambition is a health system that:

  • provides more and better care in people’s homes,
  • gets ambulances to people more quickly when they need them,
  • sees people faster when they go to hospital, and
  • helps people safely leave hospital having received the care they need.

Our support offer

Supporting systems: achieving the ambition together

NHS England and the DHSC are focussed on supporting systems to make improvements in ten key priorities (across the existing five areas of the plan set out below).

As promised when we published the plan, we are now launching the start of an improvement support offer that spans the full integrated Urgent and Emergency Care (iUEC) pathway. This support includes national tools and guidance, as well as best practice sharing and peer learning, which will enable us to:

1. Expand urgent and emergency capacity, including

  • Expanding acute bed capacity;
  • Increasing ambulance capacity; and
  • Improving processes and standardise care.

2. Increase workforce size and flexibility

3. Improve discharge, including

  • Scaling up intermediate care; and
  • Scaling up social care.

4. Expand care outside hospital, including

  • Expanding virtual wards.
5. Improve access to urgent care

Each section will shortly provide access to relevant guidance and resources, with more supporting materials added at regular intervals throughout 2023/24, so please keep checking back.

The first step: Self-assessment framework and maturity matrix

The initial stage of our improvement support is a system-wide self-assessment framework or “maturity matrix” for nine of the ten high impact interventions. Each system will lead an assessment of the services it provides – through a joint conversation with the integrated care system (ICS), providers and region – to identify opportunities for improvement and build improvement plans to support developing maturity.

This form needs to be completed and returned by noon on 28 July 2023 to england.uecassessment@nhs.net.

Recovery champions

The success of delivering the ambitions within the Urgent and Emergency Care (UEC) recovery plan relies on our frontline staff and support teams across the integrated UEC (iUEC pathway).

In recognition of this, we want to create a community, close to the frontline who can help drive system improvement. Systems are therefore being asked to nominate iUEC Recovery Champions who will support systems in these goals and also have the chance to develop themselves through training and peer-to-peer support and networking.

We recommend having 10 champions for smaller systems, while larger multi-acute provider systems may have up to 20 champions. Systems are requested to designate an executive-level point of contact, who will serve as the primary liaison for the system.

Please send the names, job titles, email addresses and employing organisations of your nominated champions to england.uecassessment@nhs.net by noon on 21 July 2023.