NAO Value for Money report - Access to unplanned or urgent care (21 June 2023)

Summary

NHS services have been under increasing pressure in recent years, particularly since the start of the Covid-19 pandemic. We have previously reported on the NHS’s efforts to tackle the backlogs in elective care and its progress with improving mental health services in England. This report gives an overview of NHS services that may be used when people need rapid access to urgent, emergency or other non-routine health services, and whether such services are meeting the performance standards the NHS has told patients they have a right to expect. It covers:

• general practice
• community pharmacy
• 111 calls
• ambulance services (including 999 calls)
• urgent treatment centres
• accident and emergency (A&E) departments.

Content

Key findings

• Population changes are contributing to increasing demand for healthcare.
• Demand for unplanned or urgent care is increasing.
• The number of general and acute hospital beds has increased slightly following a downward trend before the Covid-19 pandemic, but occupancy rates have also risen and patients are now staying longer in hospital compared with previous years.
• The number of NHS staff has increased, including those working in unplanned or urgent care.
• he number of staff vacancies across the NHS rose from the start of 2021 but has recently fallen.
• Spending on the NHS continues to increase. The total budget for NHSE in 2022-23 was £152.6 billion, some £28.4 billion more than in 2016-17 at 2022-23 prices.
• Patients’ access to services for unplanned or urgent care has worsened.
• There is considerable variation in service performance and access, both between regions and between different providers.
• Covid-19 had, and continues to have, an adverse impact on the NHS’s capacity to meet healthcare needs.
• The NHS has not met key operational standards for unplanned or urgent care since before the pandemic.
• Performance against operational standards, and more widely, has deteriorated further since the onset of the pandemic.
• Overall performance of the unplanned and urgent care system has been worsened by delays transferring patients from one service to another.
• The NHS has not been able to secure the full benefits of increased spending and staff numbers and productivity has fallen since the onset of the Covid-19 pandemic.
• NHSE has a plan to reduce waiting times and improve patients’ experiences.