Patients in the North West will receive better, faster and more appropriate emergency care as work continues in the region to shorten waiting times, reduce ambulance handover times and provide more care for people in the community rather than in hospital.

A new national Urgent and Emergency Care Plan published today (6 June) sets out a package of investment and reform to improve patients’ experiences, including initiatives to reduce long A&E waits and helping help people to be treated in the right place.

In the North West, work is already underway to meet the national target set out in the plan of 78% of people being seen and discharged, admitted or transferred within four hours of arrival at an accident and emergency department by March 2026.

Across the region, NHS A&E performance has improved by 2.4% over the past year, rising from 70.7% of people waiting 4 hours or less in March 2024 to 73.1% in March 2025, with some trusts achieving improvements of more than 5%.

In 2024/5 North West Ambulance Service was one of four ambulance services nationally to meet the national target for responding to category 2 calls for conditions such as heart attacks and strokes in under 30 minutes.

Dr Michael Gregory, Regional Medical Director for NHS England in the North West, said: “Despite rising demand and a challenging winter, NHS staff in the North West have worked incredibly hard over the past year to improve services and ensure our patients receive the highest standards of care possible.

“We’re seeing initiatives such as same day emergency care and urgent community response services helping to avoid unnecessary admissions, get people home earlier from hospital and receive more care in the community – and this in turn is having a positive impact on pressures in hospitals and emergency department waits.

“However, we know we have much further to go to deliver the services and care patients expect and deserve and we’re absolutely committed to delivering the improvements needed to achieve shorter A&E waits, improved ambulance handovers and response times and to support the shift to providing more care in the community, closer to where people live.”

Initiatives already happening across the region to help achieve many of the ambitions set out in the plan, include:

• East Lancashire Hospitals NHS Trust has introduced a range of integrated services and initiatives that support patients in their own home, working with partners such as local authorities and GPs as well as the voluntary sector. The trust’s 24/7 Intensive Home Support Service team responded to more than 10,000 urgent community responses during 2024/5, providing swift, home-based assessments and wrap around care, including interventions that would otherwise be provided in an inpatient setting, helping to prevent unnecessary admissions.

• Staff at North Manchester General Hospital, part of Manchester University NHS Foundation Trust, have reduced ambulance handover times by more than a third over the past two years after expanding the number of Rapid Access Cubicles for receiving arriving patients from four to six, introducing a senior ‘doc at the door’ to support decision-making and avoid delays. Average ambulance handover times have reduced from 27 minutes 47 seconds to 17 minutes and12 seconds, giving them the fastest handover times in the region. Similar initiatives at Manchester Royal Infirmary and Wythenshawe Hospital, part of the same hospital trust, have also achieved significant handover time reductions.

• At Bolton NHS Foundation Trust, patients are being assessed and discharged or admitted quicker thanks to a redesign of medical assessment beds and the introduction of a senior emergency medicine doctor to provide rapid assessment of patients as they arrive. Patients can be moved into a new acute assessment units (AAU) from the emergency department immediately after triage, while patients referred by their GP and brought in by ambulance can go straight to the AAU, reducing long waits and numbers in the department, which in turn is reducing the need for corridor care. The average number of people waiting in the emergency department after a decision to admit at 8am in January 2025 was 28 compared with an average of 42 in January 2024 and the average number reduced further to 18 in March, the lowest for more than two years.

• NHS England has given North West Ambulance Services £8 million to replace 40 ambulances and buy four new electric ambulances to expand their fleet – part of almost 500 to be rolled out nationally by March 2026.

• Cheshire and Wirral Partnership has just started work on a new £3.5 million Integrated Urgent Response Centre in Chester, due to open in early 2026, which will provide improved support to people experiencing a mental health crisis, reducing the need for them to attend A&E.

• At Alder Hey Children’s NHS Foundation Trust in Merseyside, building work is underway on a purpose-built facility connected to the hospital’s Emergency Department. It will be based on the ground floor of a new surgical neonatal Intensive Care Unit and will bring together the skills and expertise of paediatricians, emergency care clinicians, advanced clinical practitioners, primary care and family support workers. The new facility, which is due to open in 2026, will be home to a Paediatric Admissions Unit, Same Day Emergency Centre and Urgent Treatment Centre, enabling the trust to streamline emergency care and allowing children and young people to be seen more quickly by the most appropriate clinical team.

• Wrightington, Wigan and Leigh Hospital has placed a community admission avoidance team in the emergency department to assess and direct eligible patients for treatment in the community.  The initiative, which launched last September, helps to prevent more than 10 admissions a week and enables people to receive packages of care or physical therapy in the community.

Every day more than 140,000 people access urgent and emergency care services across England. Since 2010/11, demand has almost doubled with ambulance service usage rising by 61%.

But at least one in five people who attend A&E don’t need urgent or emergency care, while an even larger number could be better cared for in the community.

The plan focuses on making winter 2025/26 significantly better than recent winters by setting ambitious but achievable targets and increasing transparency about progress.

The plan’s emphasis is on shifting more patient care into more appropriate care settings as part of the move from hospital to community under the government’s Plan for Change to rebuild the NHS, while tackling ambulance handover delays and corridor care.

It will also deliver nationally:

• Around 40 new Same Day Emergency Care and Urgent Treatment Centres – which treat and discharge patients in the same day, avoiding unnecessary admissions to hospital.
• Up to 15 mental health crisis assessment centres to provide care in the right place for patients and avoid them waiting in A&E for hours for care, which is not the most appropriate setting for people who are experiencing a crisis. These centres will offer people timely access to specialist support and ensure that they are directed to the right care.

Almost 500 new ambulances will also be rolled out across the country by March 2026