Urgent and emergency care
We want responsive, effective and personalised care delivered in or as close as possible to our patients’ homes, for those with non-life threatening but urgent needs. For those with more serious or life-threatening emergency needs, we want treatment to be provided in centres that meet the London quality standards and have the best expertise and facilities to reduce risk and maximise chances of survival and good recovery.
The urgent and emergency care system in London is facing many challenges. An ageing population with increasingly complex needs is leading to increasing numbers of people needing urgent or emergency care. Many people are struggling to navigate and access a confusing and inconsistent array of urgent care services provided outside of hospital, which can result in them defaulting to emergency departments.
Every winter the ongoing challenges facing London’s urgent and emergency care services are highlighted further; the signs of this most visibly seen in efforts to deliver the urgent and emergency care operational four hour standard. However, the challenges for London’s urgent and emergency care services are not simply issues within emergency departments or a result of seasonal variation, issues are present all year round and across the entire care system.
This is reinforced by the NHS Five Year Forward View which outlines that urgent and emergency care services will be redesigned to integrate between emergency departments, GP out-of-hours services, urgent care centres, NHS 111, community services, and ambulance services.
Better Health for London calls for better urgent and emergency care to provide Londoners with the consistent high quality care that they expect and rightly deserve, across all seven days of the week in order to improve patient experience and outcomes.
The development and commissioning of the London quality standards for acute emergency services has led to some improvements in these services across London. The development of the national clinical standards with which the London quality standards are congruent – from the publication of Professor Sir Bruce Keogh’s Seven Day Services Forum, and their publication in December 2013, has reinforced their importance. Sanctions for non-compliance with the standards will be in place within two years, however to implement them properly requires wider system transformational change. Many service redesign programmes across London rely on issues within the urgent and emergency care system being addressed.
About the programme
The NHS in London has committed to implementing the national vision for urgent and emergency care and closing the gap in mortality rates between weekdays and weekends focussing on three key areas:
1. Establish U&EC networks to oversee the planning and delivery of the urgent and emergency care system
2. Designate urgent and emergency care facilities to ensure London quality standards are met, seven days a week
3. Improve and expand the NHS 111 system to direct patients to the most appropriate care setting to receive the right care, first time