DHSC and NHS England: Delivery plan for recovering urgent and emergency care services (30 January 2023)

Summary

To support recovery of the NHS by improving waiting times and patient experience, a joint Department of Health and Social Care (DHSC) and NHS England plan sets out a number of ambitions, including:

• Patients being seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25.
• Ambulances getting to patients quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels.

NHS England has engaged with a wide range of stakeholders to develop the plan, and it draws on a diverse range of opinion and experience, as well as views of patients and users.

The Department of Health and Social Care, who produced the content on actions being taken in social care, have led on engagement with the sector.

Content

DHSC and NHS England's delivery plan

A. Increase capacity, to help deal with increasing pressures on hospitals which see 19 in 20 beds currently occupied.

• 1. Dedicated funding of £1 billion will pay for additional capacity, including 5,000 new beds as part of the permanent bed base for next winter.
• 2. Over 800 new ambulances, including 100 specialist mental health ambulances, the majority of which will be on the road by next winter.
• 3. ‘Same day’ emergency care services will be in place across every hospital with a major emergency department, so patients avoid unnecessary overnight stays.

B. Grow the workforce, as increasing capacity requires more staff who feel supported.

• 4. More clinicians will be available for 111 online and urgent call services to offer support, advice, diagnosis and, if necessary, referral. From this April a new targeted campaign will be launched to encourage retired clinicians, and those nearing retirement, to work in 111 rather than leaving the NHS altogether.
• 5.  The workforce will grow with more flexible ways of working and increase the number of Emergency Medical Technicians next year to respond to incidents and support paramedics.

C. Speed up discharge from hospitals, to help reduce the numbers of beds occupied by patients ready to be discharged.

• 6. Over the next 2 years, and as part of the up to £14.1 billion extra for health and social care, £1.6 billion will be focused squarely on discharge.
• 7. ‘Care transfer hubs’ in every hospital ahead of next winter will mean faster discharge to the right setting, so that people do not stay in hospital longer than necessary.
• 8. This year, new approaches to step-down care will start to be implemented so, for example, people who need physiotherapy can access care as they are being discharged from hospital before they need to be assessed by their local authority for long-term care needs.
• 9. New discharge information will be published, with new data collected from this April.

D. Expand new services in the community, as up to 20% of emergency admissions can be avoided with the right care in place.

• 10. Ahead of next winter the government will offer more joined-up care for older people living with frailty, including scaling urgent community response, frailty and falls services across the whole country – meaning the right people help you get the care you need, without needing an admission to hospital if it’s not necessary.
• 11. Greater use of ‘virtual wards’, which allow people to be safely monitored from the comfort of their own home, will be achieved by an extra 3,000 beds to provide over 10,000 in total by this autumn, allowing staff to care for up to 50,000 patients a month this way over the longer term.
• 12. Help people access the right care first time, as 111 should be the first port of call and reduce the need for people to go to A&E. By April 2024, urgent mental health support through NHS 111 will be universally available.
• 13. From this April, new data will allow the public to easily see and compare the performance of their local services. It will also tackle unwarranted variation in performance in the most challenged local systems.
• 14. This April, a new clinically-led programme to reduce unwarranted variation will launch, alongside intensive support for those areas struggling the most