*Updated 27 November 2023*
This fact sheet sets out actions the Department of Health and Social Care and NHS England are taking to improve urgent and emergency care (UEC) performance in England, including ambulance response times, A&E waiting times and hospital discharge.
Backed by record funding, we are supporting the NHS to offer patients the highest quality care, when and where they need it, this winter.
What is your plan to address pressures across urgent and emergency care?
- The pandemic put huge pressure on the NHS and cutting waiting times is one of the government’s top five priorities.
- As part of this, we have published our ambitious Delivery Plan for Recovering Urgent and Emergency Care Services to rapidly reduce waiting times, building on action taken by the NHS last winter.
- The NHS is expanding high-tech virtual wards – ‘hospitals from home’ and the NHS has surpassed its target to support 10,000 people to recover in the comfort of their homes.
- Ahead of winter, ‘same day’ emergency care services will be in place across every hospital with a major emergency department, so patients avoid unnecessary overnight stays.
- Up to 20% of emergency hospital admissions are avoidable with the right care in place, so we are transforming urgent care in the community. This includes scaling up urgent community response teams and falls and frailty services to help people get the care they need at home.
- NHS 111 will be enhanced with more clinicians – including retired staff and returners – working in the service, increased access to specialist paediatric advice for children and direct access to urgent mental health support.
- Since the launch of the plan, we have seen a marked improvement in both A&E waits and ambulance response times. For example, average response times to Category 2 ‘emergency’ incidents – including serious incidents such as heart attacks and strokes – was almost 20 minutes faster this October than the same month last year.
Specifically, we are providing funding to allow the health and social care system to prepare well for this coming winter, including:
- £1 billion to increase capacity in urgent and emergency care, including creating 5,000 additional beds this winter. This will help reduce waits for emergency admissions and avoid overcrowding in A&E, helping patients to be seen quickly.
- The ambulance service is also receiving £200 million of additional funding this year, alongside 800 new ambulances to grow capacity and improve response times.
- We have provided £800 million - a combination of reprioritised and new funding - to ensure that patients continue to receive the highest quality care this winter and ease pressure on hospitals
- £250 million to create 900 beds across 30 NHS Trusts, as part of creating 5,000 additional beds. This includes developing or expanding urgent treatment centres and same day emergency care services which will help patients to be seen more quickly, without being admitted to hospital.
- £50 million to help free up hospital beds and cut down on waiting times for patients. Six new ambulance hubs and 42 new and upgraded discharge lounges are opening at hospitals across the country, which will help cut urgent and emergency care waiting times for tens of thousands of patients.
What are you doing to help mitigate pressures on the NHS ahead of winter?
- We have started preparing for winter earlier than ever and have taken significant action since last year.
- We have put in place recovery plans across urgent and emergency care services and primary care, as well as building on the elective services recovery plan already published. This has provided a strong basis for winter preparations earlier than ever before.
- To increase activity, we are using the independent sector more effectively so patients can be treated more quickly. There are currently 127 community diagnostic centres which have delivered more than 5 million additional checks, scans, tests and operations, speeding up access to services and reducing pressure on hospitals.
- Taken together along with the additional funding, these measures will ensure we continue to make significant progress in tackling the backlogs.
- In July NHS England wrote to the system to set out the national approach to 2023/24 winter planning, and the steps to be taken across all parts of the system to meet the challenges expected from winter pressures
- NHSE launched a new tiered improvement support approach to help our most challenged systems and trusts and have already nominated over 1,000 Recovery Champions to help systems identify their priorities for this year.
- We have brought forward the Flu and COVID-19 vaccination delivery programme – which began on 11 September – as a precautionary measure, to protect the most vulnerable from illness during winter.
- The NHS is prioritising urgent and cancer care and will continue to do its best to maintain appointments and elective procedures wherever possible. Cancelled appointments that need to be rescheduled will be done so as a priority.
What targets is the NHS working towards?
- The two-year plan aims to stabilise services to meet the NHS’s two major recovery ambitions:
- Achieve A&E four-hour performance of 76% by March 2024
- Improve Category 2 ambulance response times to an average of 30 minutes this year, and return to pre-pandemic levels next year.
- These ambitions represent one of the fastest and longest sustained improvements in emergency waiting times in the NHS’s history.
Where will the new hospital beds be located?
- Each area of the country has reviewed where there is the greatest need for additional hospital capacity and drawn up plans to deliver this.
- These plans take into account where there is existing room in hospitals and where additional capacity such as modular wards may be needed, as well as the additional staff and accompanying support services that will be required.
What drives winter pressures?
- Winter is always a challenging time for the NHS with seasonal respiratory viruses in circulation – alongside potential increases in demand from COVID-19.
- In the longer term, demand on the NHS is rising, driven by a number of factors including an ageing population with increasingly complex needs.
What are your plans to grow the workforce to deliver the UEC Recovery plan?
- We have made significant progress in growing the workforce with record numbers of staff working in the NHS.
- We are also implementing the first ever NHS Long Term Workforce Plan, backed by over £2.4 billion in government funding, which will deliver the biggest expansion of staff training in NHS history.
- Changes aimed at growing and better supporting the workforce will give NHS staff greater flexibility, making it easier for them to move between hospitals and work in services like 111, with more options for call handlers to work from home.
- NHS 111 services are being supported through a targeted campaign to encourage retired clinicians, and those nearing retirement, to work in 111 rather than leaving the NHS altogether. This will help to ensure more clinicians available for 111 online and urgent call services to offer support, advice, diagnosis and, if necessary, referral.
- We have increased the number of NHS ambulance staff and support staff by over 45% since 2010.
- The number of emergency medical technicians will also be expanded, providing another entry route to working in the NHS, alongside greater use of student and apprentice paramedics and training more staff in mental health.
- Alongside this, 3,000 student paramedics are expected to complete their training in 2023/24, with a further 2,300 expected in 2024/25.
How are you ensuring people can leave hospital when they’re ready?
- We know there are many patients in hospital beds who don’t need to be, so our Delivery Plan for Recovering Urgent and Emergency Care Services sets out a number of targeted actions which will ensure patients can be safely discharged from hospital when ready, backed by a targeted £1.6 billion fund to boost capacity and staff in social care.
- We will be looking closely at the impact of the funding, conducting a comprehensive evaluation and using this data to inform future policy and funding decisions.
- We are supporting all systems to improve their care transfer hubs ahead of winter through a UEC Recovery Plan support offer which includes webinars, actions learning sets and sharing best practice.
- Care transfer hubs link across health, social care, voluntary sector and housing partners to coordinate complex discharges and ensure that patients are discharged in a safe and timely way, either to their home or to a place in which long-term care decisions can best be made, with rehabilitation and recovery support.