Improving discharge and access to urgent care

For decades we have known that many patients can receive better, safer, more convenient care outside hospital and so backing these models can give a better experience for patients and avoid unnecessary admissions and improve discharge.

We will do this by expanding and better joining up new types of care outside hospital and expanding virtual wards.

Expanding and better joining up new types of care outside hospital

We know that up to 20% of emergency admissions are potentially avoidable with the right care in place.

Personalised care approaches and community health services can reduce pressures on hospitals and emergency services by supporting patients at home and in the community, as well as provide them with greater choice and control, leading to improved patient experience and outcomes.

Our plan focusses on improving the use of urgent community response (UCR) teams, scaling up falls and frailty services, continuing the roll out adult and paediatric Acute Respiratory Infection (ARI) Hubs (where most beneficial) as well as continuing the transformation of community mental health services.

Expanding virtual wards

Virtual wards can bridge the gap between hospitals and patients’ homes, enabling patients to remain in their own home supported by family or carers to recover more quickly in a more comfortable environment. And the evidence base for virtual wards is growing, with clinical evidence to show that virtual wards are a safe and efficient alternative to NHS bedded care, particularly for patients living with frailty.

The NHS has successfully rolled out 7,000 virtual ward beds, with our ambition to scale up capacity ahead of this winter to above 10,000 with a longer-term ambition of reaching 40-50 virtual wards per 100,000 people.

National and regional support will be provided here through tools and resources to enable service review, clinical audit and approaches to diagnostics and tech enablement.

Guidance and resources

Expanding integrated urgent and emergency care capacity

Expanding acute capacity

Through additional funding the NHS has already increased the number of staffed hospital beds, with more to come.

As we know there is a well-established link between high bed occupancy rates in hospitals and worse A&E performance.

So there will be 5,000 more staffed, sustainable beds in 2023/24 in the places that will deliver the greatest benefit to patients and allocated in a fair way across the country.

Increasing ambulance capacity

Over 800 new ambulances are expected to be available during 2023/24, with the majority expected to be available ahead of winter, as part of ongoing improvement and replacement of our fleet, including 100 new specialist mental health response vehicles.

Systems are asked to implement a single point of access for paramedics to ensure consistent and rapid access to clinical advice and alternative services, which will help to reduce unnecessary conveyance.

In addition, increasing clinical assessment of calls in every ambulance control centre will ensure that the sickest patients are prioritised for ambulances and that patients who do not need a face-to-face response can be transferred quickly to services more appropriate for their needs.

Improving processes and standardising care

We know from patients how important it is to have a smooth experience in hospital but there is still significant variation between processes in hospitals, with opportunities to learn from where things are being done best and with a less confusing experience for patients.

As we increase capacity, we will use existing capacity as effectively as possible by standardising processes so that patients get the right care at the right time, including when moving between organisations.

NHS England has established a new improvement programme to support standardisation of care, working with clinical leadership to set out common principles for providers, including developing professional networks to support peer-to-peer learning and challenge, leadership and best practice.