‘Blame shunting’ by providers leads to poor emergency care, says NHSE

The ‘inability or unwillingness’ of some NHS and social care providers to work together has contributed to an ‘unimaginable’ deterioration in emergency care performance, according to NHS England

The claim is made in the urgent care recovery plan for 2025-26, released by NHS England and the Department of Health and Social Care.

The plan includes a new target to reduce 12-hour accident and emergency waits and pledges to invest £370m of capital funding in improving urgent care and mental health facilities.

The plan said, “Each part of the system has responsibility for improving urgent and emergency care performance. However, blame shunting has become a feature in some poorly performing systems and can no longer be tolerated."

National urgent care director Sarah-Jane Marsh told HSJ that “the duty to collaborate and work together and do the best for patients is on all trust boards, and it shouldn’t rely on some overseer to make sure that happens. It’s a fundamental part of being a leader”.

Trusts will be told to ensure the proportion of patients waiting over 12 hours for admission, transfer or discharge from A&E remains less than 10%.

The 45-minute “maximum” ambulance handover time will become mandatory across all trusts ahead of winter, according to the plan. 

Chief executive of the College of Paramedics, Tracy Nicholls, said, “The plan sets out progressive structural proposals that have the potential to enhance public safety and strengthen paramedic autonomy. However, it may underestimate key challenges, including workforce readiness, the capacity of the mental health system, and practical implications of the Right Care, Right Person model. Without urgent alignment of funding, training, and alternative care pathways, there is a real risk that paramedics could be left navigating a reform process that shifts responsibility without equipping them with the necessary tools and support.

Read full story (paywalled)

Source: HSJ, 5 June 2025

Related reading on the hub:

• How corridor care in the NHS is affecting safety culture: A blog by Claire Cox
• My experience of the 'Wait 45' policy - Florence in the Machine
• A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift