* Updated 29 March 2023*
This fact sheet sets out action the Department of Health and Social Care and NHS England are taking to improve urgent and emergency care performance including ambulance handover times, A&E waiting times and hospital discharge.
Q: What is your plan to address pressures across urgent and emergency care?
- The pandemic, Covid and flu cases have put huge pressure on the NHS and cutting waiting times is one of the government's top five priorities for this country.
- As part of this the NHS and government have published an ambitious and credible plan to rapidly reduce waiting times for urgent and emergency care, building on action taken by the NHS this winter.
- We will do this partly by increasing capacity, with 800 new ambulances on the road, including 100 specialist mental health vehicles, and 5,000 new hospital beds, backed by a £1 billion dedicated fund to stop bottlenecks outside A&E and make sure patients are seen quickly.
- We know up to 20% of emergency hospital admissions are avoidable with the right care in place so we will transform 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.
- Ahead of next winter, 'same day' emergency care services will be in place across every hospital with a major emergency department, so patients avoid unnecessary overnight stays.
- The NHS will also expand high-tech virtual wards, with up to 7,000 people already supported by clinicians to recover in the comfort of their homes, and up to 50,000 patients a month expected to benefit by the end of 2023/24.
- And 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.
Q: What are your plans to grow the workforce to deliver this plan?
- 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.
- 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.
- We will increase the size of the workforce, with the NHS due to publish an independently verified workforce plan in the spring, with projections for how many staff we will need over the next 5, 10 and 15 years.
Q: What new data will you publish on urgent and emergency care performance?
- We will improve transparency and access to data about what is happening on the front line.
- As part of this, the NHS will start to publish data on 12-hour delays from time of arrival in A&E from April to help bring down waiting lists. As a result, the public will be able to more easily see and compare the performance of their local services.
Q: Are you investing more money to deliver this plan?
- The plan is backed by record funding with up to £14.1 billion announced in the Autumn Statement for health and social care over the next two years.
- From this, a £1 billion dedicated fund will be established to stop bottlenecks outside A&E and make sure patients are seen quickly.
- This includes up to £7.5 billion available over the next two years to support adult social care and discharge and an additional £6.6 billion to the NHS over the next two years.
Q: What targets is the NHS working towards?
- The two-year plan aims to stabilise services to meet the NHS's two major recovery ambitions, to help achieve A&E four-hour performance of 76% by March 2024 and improve category two ambulance response times to an average of 30 minutes over the next year, and down towards pre-pandemic levels within two years.
- These ambitions represent one of the fastest and longest sustained improvements in emergency waiting times in the NHS's history.
Q: Where will the new hospital beds be located?
- Over the coming weeks each area of the country will review where there is the greatest need for additional hospital capacity and draw up plans.
- They will 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.
Q: 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 Urgent and Emergency Care Plan 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.
- It follows the announcement in January of up to £200 million of additional funding available to immediately buy short-term care placements to allow people to be discharged safely from hospitals, along with £50 million in capital funding to upgrade and expand hospitals including new ambulance hubs and facilities for patients about to be discharged.
- This is also on top of the £500 million Discharge Fund provided to local areas to speed up the discharge of patients from hospital.
- Local areas will determine how to spend their allocations which might be through purchasing supportive technology, boosting domiciliary care capacity, or investing in staff recruitment, such as physiotherapists and occupational therapists, to support recovery at home.
- 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.
Q. What is driving winter pressures?
- Winter is always a challenging time for the NHS with seasonal respiratory viruses in circulation.
- The pandemic placed huge pressure on the NHS, and many systems including primary care and community services are still recovering. Before the pandemic there were 1,600 people waiting more than 52 weeks for an operation - that number is now nearly 380,000.
- High levels of Covid and flu cases as well as a surge in Strep A have added to these pressures.
- In the longer term, demand on the NHS is rising, driven by a number of factors including an ageing population with increasingly complex needs.
Q: What is the cause of the rise in excess deaths?
- We knew during the pandemic many of the measures taken would have an impact on excess deaths, including delays to treatment, operations taking longer and cardiovascular conditions. There are also other factors and other countries across Europe are facing similar circumstances such as in France and Germany.
- There are a wide variety of factors contributing to excess deaths. The Health and Social Care Secretary continues to receive regular briefings and it is important not to ascribe all excess deaths to one cause. Some of the increase in excess mortality is due directly to Covid and some indirectly.