*Updated 23 April 2024*
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.
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, last January we published our 2-year Delivery Plan for Recovering Urgent and Emergency Care Services to drive sustained improvements in urgent and emergency care waiting times.
- The NHS is expanding high-tech virtual wards, known as ‘hospitals from home’. The NHS has surpassed its target to deliver 10,000 virtual ward beds – there are almost 12,000 as of March 2024 – allowing people to recover in the comfort of their homes.
- Same day emergency care services are now in place across every hospital trust 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 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 – were over thirteen minutes faster in 2023/24 compared to the previous year.
Specifically, we are providing funding to increase capacity in the health and social care system this winter and beyond, including:
- £1 billion of dedicated funding to support capacity in urgent and emergency care services in 2023/24. This funding will be maintained in 2024/25. We have delivered 5,000 additional beds over winter compared to planned 2022/23 levels to help reduce waits for emergency admissions and avoid overcrowding in A&E, helping patients to be seen quickly.
- £250 million to create 900 beds across 30 NHS Trusts, as part of the 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.
- 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
- The ambulance service is being supported with £200 million of additional funding, alongside new ambulances and specialist mental health vehicles to grow capacity and improve response times.
- Backed by nearly £50 million in investment, we have already delivered six new ambulance hubs and many of the 42 new or upgraded discharge lounges have already opened at hospitals across the country, which will help cut urgent and emergency care waiting times for tens of thousands of patients.
What did you do to help mitigate pressures on the NHS ahead of winter 2023/24?
- We started preparing for winter 2023/24 earlier than ever and have taken significant action since last winter.
- We have put in place recovery plans across urgent and emergency care services and primary care, as well as building on the Elective recovery plan already published. This has provided a strong basis for winter preparations earlier than ever before.
- In July 2023 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 nominated over 1,000 Recovery Champions to help systems identify their priorities.
- Community Diagnostic Centres (CDCs) are an essential part of the overall aim to more clearly separate urgent and elective care, by taking patients requiring diagnostic services away from acute areas, therefore removing the risk of the estate being reprioritised for urgent work. The CDC programme is now delivering activity on 160 sites which has delivered almost 8 million additional checks, scans, and tests since July 2021.
- There are 100 elective surgical hubs operational across England as of February 2024. Surgical hubs provide ringfenced elective capacity, protecting elective care from acute pressures including winter.
- To increase activity, we are using the independent sector more effectively so patients can be treated more quickly.
- Taken together along with the additional funding, these measures will ensure we continue to make significant progress in tackling the backlogs.
- We brought forward the Flu and COVID-19 vaccination delivery programme – which began on 11 September 2023 – 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 meet two major recovery ambitions:
- Achieve a minimum A&E four-hour performance of 78% by March 2024
- Improve Category 2 ambulance response times to an average of 30 minutes over this year 2024/25.
- These ambitions represent one of the fastest and longest sustained improvements in emergency waiting times in the NHS’s history.
Where have the new hospital beds been 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 cold weather.
- 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.
- We have increased the number of NHS ambulance staff and support staff by over 50% since 2010.
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.
- This year, the government is providing £1 billion through the 2024/25 Discharge Fund to support the NHS and local authorities to ensure timely and effective discharge from hospital. This funding follows £600 million last year.
- 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 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.
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