New blueprint for urgent and emergency care across England


13 / 11 / 2013 12.01pm

The report aims to set out a long term vision for emergency care and proposes designating 40 to 70 A&E units as major centres, which will include specialist services for heart attack, trauma, stroke and critically ill children, with the remaining 70 to 100 units to be known as emergency centres, dealing with less seriously ill patients.

The report makes proposals in five key areas:

  • Provide better support for people to self-care – The NHS will provide better and more easily accessible information about self-treatment options so that people who prefer to can avoid the need to see a healthcare professional.
  • Help people with urgent care needs to get the right advice in the right place, first time – The NHS will enhance the NHS 111 service, creating a 24 hour, personalised priority contact service which will have knowledge about people’s medical problems and allow them to speak directly to healthcare professionals or directly book a call back from, or an appointment with, a GP or the most suitable emergency care facility.
  • Provide highly responsive urgent care services outside of hospital so people no longer choose to queue in A&E - putting in place faster and consistent same-day, every-day access to general practitioners, primary care and community services such as local mental health teams and community nurses to address urgent care needs; harnessing the skills, experience and accessibility of community pharmacists; developing 999 ambulance services into a mobile urgent treatment service capable of treating more patients at scene.
  • Ensure that people with more serious or life threatening emergency needs receive treatment in centres with the right facilities and expertise to maximise chances of survival and a good recovery. Once it has enhanced urgent care services outside hospital, the NHS will introduce two types of hospital emergency department with the current working titles of Emergency Centres and Major Emergency Centres. Emergency Centres will be capable of assessing and initiating treatment for all patients and safely transferring them when necessary. Major Emergency Centres will be much larger units, capable of not just assessing and initiating treatment for all patients but providing a range of highly specialist services.
  • Connect urgent and emergency care services so the overall system becomes more than just the sum of its parts. Building on the success of major trauma networks, the NHS will develop broader emergency care networks. These will dissolve traditional boundaries between hospital and community-based services and support the free flow of information and specialist expertise.

Next steps

Phase two of the review is currently underway and the expectation is that that while it will take three to five years to make the necessary change, significant progress will be made over the next six months on the following areas:

  • working closely with local commissioners as they develop their five-year strategic and two-year operational plans
  • identifying and initiating transformational demonstrator sites to trial new models of delivery for urgent and emergency care and seven-day services
  • developing new payment mechanisms for urgent and emergency care services, in partnership with Monitor
  • completing new NHS 111 service specification so that the new service – which will go live during 2015/16 – can meet the aspirations of the review.

We will continue to keep you informed as the plans progress in this area.

Find out more

The full report, Transforming urgent and emergency care services in England, is now available on the NHS England website.

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