Urgent and Emergency Care (UEC) services perform a critical role in keeping the population healthy. The NHS responds to more than 110 million urgent calls or visits every year, so it is essential that the system works effectively.
Both urgent and emergency care services play a specific part in supporting patients to receive the right care, by the right person, as quickly as possible.
Emergency care
Emergency care involves life-threatening illnesses or accidents which require immediate treatment from the ambulance service (via 999) and an emergency department (A&E).
Urgent care
Urgent care involves any non-life-threatening illness or injury needing urgent attention which might be dealt with by phone consultation through the NHS111 Clinical Assessment Service, pharmacy advice, out-of-hours GP appointments, and/or referral to an urgent treatment centre (UTC). If you’re unsure if you need urgent medical help then NHS 111 can help.
Recovery of UEC services
Increasing pressure on emergency services, and changing technology and population needs mean the UEC system must adapt to ensure a service fit for the future.
Our UEC Recovery Plan sets out how the NHS and system partners will begin to transform how patients access urgent and emergency care. It also sets out the actions being taken in social care to support improvements in discharge, led by the Department of Health and Social Care.
National Elective and Emergency Care Directorate
The NHS England Elective and Emergency Care (EEC) directorate provides national guidance and support to drive continuous improvement in elective and urgent and emergency care services across the NHS.
The EEC directorate works in partnership with other NHS organisations, system leaders, frontline staff, patients, and key stakeholders, such as royal colleges to design, develop, and implement best practice models of care that ensure patients see the right person, in the right place, as quickly as possible.
The Urgent and Emergency Care (UEC) programme of the national directorate comprises of the following workstreams:
- Integrated Urgent Care
- Urgent Treatment Centres
- Ambulance
- Hospitals
- Clinical Review of NHS Access Standards
- Reducing Length of Stay
Our work to date
We are continuously building on previous improvement efforts to ensure a learning system that shares knowledge and insight gained through policy development and practical experience.
Progress in transforming UEC services over the past few years includes:
- 100% of the population of England are now able to access urgent care advice through the NHS 111 online service.
- Development of the Integrated Urgent Care Service, so that more than half of the number of people calling NHS 111 now receive a clinical assessment and can be offered immediate advice or referred to the appropriate clinician for a face-to-face consultation.
- Began roll-out of urgent treatment centres across the country, providing a locally accessible and convenient service offering diagnosis and treatment of many of the most common reasons people attend A&E.
- Introduced new standards for ambulance services to ensure that the sickest patients receive the fastest response, and that all patients get the response they need first time.
- Introduced a national Same Day Emergency Care (SDEC) model for hospitals, building on existing Ambulatory Emergency Care (AEC) efforts and reducing the number of patients admitted overnight for an emergency.
- The establishment of an Acute Frailty programme to ensure the identification of frail patients within a few hours of their arrival to hospital and enable prompt, targeted management based on a comprehensive geriatric assessment approach.
- Progress on reducing health inequalities in UEC services includes:
The development of a Homelessness and rough sleeping (HRS) pathway, checklist and toolkit to directly improve HRS patient experience and outcomes alongside realising potential benefits including reduction in ED conveyance, attendance, and admission alongside reducing levels of re-attendance and re-admission. Further information can be found on FutureNHS. For any queries please contact england.emergingpolicy-uec@nhs.net.
NHS Long Term Plan
The NHS Long Term Plan was published in January 2019 and sets out an ambitious vision for the future of the NHS. Over the next 10 years, NHS organisations will work together to ensure a service in which patients get more options, better support, and more joined up care.
Commitments made in the Long Term Plan for urgent and emergency care services include:
- Providing a 24/7 urgent care service, accessible via NHS 111, which can provide medical advice remotely and if necessary, refer directly to Urgent Treatment Centres (UTCs), GP (in and out of hours), and other community services (pharmacy etc.), as well as ambulance and hospital services.
- Implementing Same Day Emergency Care (SDEC) services across 100% of type 1 emergency departments, allowing for the rapid assessment, diagnosis, and treatment of patients presenting with certain conditions, and discharge home same day if clinically appropriate.
- Focusing efforts to reduce the length of stay for patients in hospital longer than 21 days, reducing the risk of harm and providing care in the most clinically appropriate setting.
- Working closely with primary and community care services to ensure an integrated, responsive healthcare service helping people stay well longer and receive preventative or primary treatment before it becomes an emergency.
