Urgent and Emergency Care (UEC) services perform a critical role in keeping the population healthy. The NHS responds to more than 110 million urgent calls or visits every year, so it is essential that the system works effectively.
Both urgent and emergency care services play a specific part in supporting patients to receive the right care, by the right person, as quickly as possible. To help relieve pressure on A&E departments and to ensure patients get the right care, it is important to understand the difference between urgent and emergency care;
- Emergency: Life threatening illnesses or accidents which require immediate, intensive treatment. Services that should be accessed in an emergency include ambulance (via 999) and emergency departments.
- Urgent: An illness or injury that requires urgent attention but is not a life-threatening situation. Urgent care services include a phone consultation through the NHS111 Clinical Assessment Service, pharmacy advice, out-of-hours GP appointments, and/or referral to an urgent treatment centre (UTC). If unsure what service is needed, NHS111 can help to assess and direct to the appropriate service/s.
With increasing pressure on emergency services, and as technology and the needs of the population change, the UEC system must also change to ensure a service fit for the future. Improvement initiatives are being implemented across the NHS to reduce pressure and simplify urgent and emergency services, resulting in better outcomes of care and experience for staff and patients.
Action plan for recovery of UEC services
This year has seen significant pressure put on urgent and emergency care (UEC), but the NHS is working together to implement a plan to ensure a strong recovery across all UEC services. This focuses on:
- Supporting 999 and 111 services.
- Supporting primary care and community health services to help manage the demand for UEC services.
- Supporting greater use of urgent treatment centres.
- Increasing support for children and young people.
- Using communications to support the public to choose services wisely.
- Improving in-hospital flow and discharge.
- Supporting adult and children’s mental health needs.
- Reviewing infection prevention and control measures to ensure a proportionate response.
- Reviewing staff COVID isolation rules.
- Ensuring a sustainable workforce.
National Elective and Emergency Care Directorate
The NHS England and NHS Improvement Elective and Emergency Care (EEC) Directorate provides national guidance and support to drive continuous improvement in elective and urgent and emergency care services across the NHS.
The EEC Directorate works in partnership with other NHS organisations, system leaders, frontline staff, patients, and key stakeholders, such as Royal colleges to design, develop, and implement best practice models of care that ensure patients see the right person, in the right place, as quickly as possible.
The Urgent and Emergency Care (UEC) programme of the national Directorate comprises of the following workstreams:
- Integrated Urgent Care
- Urgent Treatment Centres
- Clinical Review of NHS Access Standards
- Reducing Length of Stay
Our work to date
We are continuously building on previous improvement efforts to ensure a learning system that shares knowledge and insight gained through policy development and practical experience.
Progress in transforming UEC services over the past few years includes:
- 100% of the population of England are now able to access urgent care advice through the NHS 111 online service.
- Development of the Integrated Urgent Care Service, so that more than half of the number of people calling NHS 111 now receive a clinical assessment and can be offered immediate advice or referred to the appropriate clinician for a face-to-face consultation.
- Began roll-out of urgent treatment centres across the country, providing a locally accessible and convenient service offering diagnosis and treatment of many of the most common reasons people attend A&E.
- Introduced new standards for ambulance services to ensure that the sickest patients receive the fastest response, and that all patients get the response they need first time.
- Introduced a national Same Day Emergency Care (SDEC) model for hospitals, building on existing Ambulatory Emergency Care (AEC) efforts and reducing the number of patients admitted overnight for an emergency.
- The establishment of an Acute Frailty programme to ensure the identification of frail patients within a few hours of their arrival to hospital and enable prompt, targeted management based on a comprehensive geriatric assessment approach.
NHS Long Term Plan
The NHS Long Term Plan was published in January 2019 and sets out an ambitious vision for the future of the NHS. Over the next 10 years, NHS organisations will work together to ensure a service in which patients get more options, better support, and more joined up care.
Commitments made in the Long Term Plan for urgent and emergency care services include:
- Providing a 24/7 urgent care service, accessible via NHS 111, which can provide medical advice remotely and if necessary, refer directly to Urgent Treatment Centres (UTCs), GP (in and out of hours), and other community services (pharmacy etc.), as well as ambulance and hospital services.
- Implementing Same Day Emergency Care (SDEC) services across 100% of type 1 emergency departments, allowing for the rapid assessment, diagnosis, and treatment of patients presenting with certain conditions, and discharge home same day if clinically appropriate.
- Focusing efforts to reduce the length of stay for patients in hospital longer than 21 days, reducing the risk of harm and providing care in the most clinically appropriate setting.
- Working closely with primary and community care services to ensure an integrated, responsive healthcare service helping people stay well longer and receive preventative or primary treatment before it becomes an emergency.