The NHS urgent and emergency care system is a critical component of the healthcare infrastructure, providing immediate clinical attention to those in need. However, the system faces significant challenges, including increasing demand, long waiting times, and resource constraints. Transforming urgent and emergency care is essential to ensure that patients receive timely, efficient, and high-quality care.

The urgent and emergency care plan 2025/26 highlights the need for a whole-system approach to improve urgent and emergency care (UEC) to deliver improved services, in particular, winter pressures on patients and staff.

This blog explores strategies for transforming NHS urgent and emergency care and how the 10-year plan can support these efforts.

Current Challenges in Urgent and Emergency Care

1. Increasing Demand: According to the NHS, over 140,000 people access UEC services in England. The number of patients seeking urgent and emergency care has been rising steadily, driven by an ageing population, higher incidence of chronic conditions, and seasonal variations.
2. Long Waiting Times: At least 1 in 5 people who attend the emergency department don’t need urgent or emergency care, and patients often face long waiting times, leading to delays in receiving care and increased pressure on healthcare staff.
3. Resource Constraints: Staffing shortages, limited bed availability, and inadequate infrastructure contribute to the challenges faced by urgent and emergency care services.
4. Fragmented Care: Lack of coordination between different parts of the healthcare system can result in fragmented care, where patients experience delays and inefficiencies in their treatment journey. Approximately 20% of emergency admissions are considered avoidable with better primary and community care.

Strategies for Transforming Urgent and Emergency Care

1. Integrated Care Systems (ICS)
   Collaboration: Integrated Care Systems (ICS) bring together NHS organisations, local authorities, and other partners to plan and deliver health and care services collaboratively. This approach ensures that care is coordinated and that resources are used efficiently.
   Community-Based Care: Shifting care from hospitals to community settings can help reduce the burden on emergency departments. This includes expanding services such as urgent community response teams and virtual wards.
2. Digital Transformation
   Electronic Health Records (EHRs): Implementing comprehensive EHR systems allows for seamless sharing of patient information across different healthcare providers, improving coordination and reducing duplication of efforts.
   Telehealth: Telehealth services enable patients to receive medical consultations remotely, reducing the need for in-person visits and easing the pressure on emergency departments.
3. Optimising Patient Flow
   Efficient Triage Systems: Implementing effective triage systems ensures that patients are assessed quickly and directed to the appropriate level of care based on the severity of their condition.
   Streamlined Processes: Developing integrated care pathways that streamline the patient journey from arrival to discharge can reduce delays and improve the overall efficiency of urgent and emergency care services.
4. Workforce Development
   Training and Support: Providing ongoing training and support for healthcare staff is essential for maintaining high standards of care. This includes training on communication skills, empathy, and patient-centered care.
   Recruitment and Retention: Addressing staffing shortages through targeted recruitment and retention strategies can help ensure that urgent and emergency care services are adequately staffed.

The Role of the 10-Year Plan

The NHS 10-year plan outlines a comprehensive strategy for transforming healthcare services, including urgent and emergency care. Key elements of the plan that support this transformation include:

1. Investment in Digital Infrastructure
   Connected Care Records: The plan includes significant investment in digital infrastructure, such as the Connected Care Records program, which aims to give healthcare providers a unified view of patients’ needs, conditions, and treatment history.
   Data Transparency: The plan commits to publishing A&E performance data from each hospital, promoting transparency and accountability.
2. Focus on Prevention and Early Intervention
   Preventive Care: The plan emphasises the importance of preventive care and early intervention to reduce the demand for urgent and emergency services. This includes initiatives to improve vaccination rates and promote healthy lifestyles.
   Community-Based Services: Expanding community-based services, such as urgent community response teams and virtual wards, helps manage patients’ needs closer to home and reduces the burden on emergency departments.
3. Improving Patient Flow and Reducing Delays
   Ambulance Handover Times: The plan sets targets for reducing ambulance handover times to ensure that ambulances are available to respond to emergencies promptly. More than 1 in 4 ambulance handovers experienced a delay of at least 30 minutes in 2024/25.
   Reducing Long Stays: Efforts to reduce long stays in emergency departments and improve discharge processes are critical for enhancing patient flow and ensuring timely care.
4. Mental Health Integration
   Crisis Assessment Centres: The plan includes funding for dedicated mental health crisis assessment centres, reducing the need for mental health patients to seek help via A&E.
   24-Hour Waits: Specific targets are set to reduce 24-hour waits in A&E for mental health patients, ensuring that they receive timely and appropriate care.

Conclusion

Transforming NHS urgent and emergency care is essential for meeting the growing demands and ensuring that patients receive high-quality care. By leveraging integrated care systems, digital transformation, optimised patient flow, and workforce development, the NHS can address current challenges and improve urgent and emergency care services.

The 10-year plan provides a comprehensive framework for achieving these goals, with a focus on digital infrastructure, preventive care, patient flow, and mental health integration. As these initiatives are implemented, the NHS will be better equipped to provide timely, efficient, and compassionate care to those in need.