NHS England’s Plan to Recover Urgent and Emergency Care Services

The NHS and UK Government have published a new two-year delivery plan today to help recover urgent and emergency care services, reduce waiting times, and improve patient experience.
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To support recovery, this plan sets out five key ambitions, including to:

  • Increase bed and ambulance capacity, to help deal with increasing pressures on hospitals which see 19 in 20 beds currently occupied.
  • Grow the workforce, as increasing capacity requires more staff who feel supported.
  • Speed up discharge from hospitals, to help reduce the numbers of beds occupied by patients ready to be discharged.
  • Expand new services in the community, as up to 20% of emergency admissions can be avoided with the right care in place.
  • Help people access the right care first time, as 111 should be the first port of call and reduce the need for people to go to A&E.

The plan focuses predominantly on the need to improve hospital discharge and join-up with adult social care, reflecting the challenges of an ageing population and frailty. However, we know that children's urgent and emergency care has also faced unprecedented levels of demand and that some of the drivers of this are different than for adults. 
As part of the plan there are a number of welcome solutions to improve paediatric urgent and emergency care. These are:  

  • Expanding advice offered through NHS.UK and NHS111 online to support decision making for young people and families, including self-care and management 
  • More paediatric specialist input for children and young people embedded within 111
  • National roll-out of a standardised paediatric early warning system (PEWS)
  • Spreading best practice models of Same Day Emergency Care 
  • Roll out of acute paediatric respiratory hubs for children ahead of next winter
  • Expansion of virtual wards, with priority pathways for paediatrics.
  • Embedding family support workers in A&E settings to provide additional support to children and families presenting with non-urgent medical issues but overlapping needs

Implementation planning has not yet been outlined, or how the £1 billion funding will be used. 

RCPCH President, Dr Camilla Kingdon said:

Paediatricians know that winter is typically our busiest season.  However, this winter has been particularly gruelling after a relentlessly busy 2022. Alongside the increased levels of COVID and flu highlighted by the plan, child health teams also saw elevated levels of Group A Strep which put significant pressure on an already fragile paediatric urgent and emergency care system. In December we saw children waiting for more than 10 hours for treatment in A&E, with an average of just 30 PICU beds available across the country in the first two weeks of December, and calls to NHS 111 skyrocketing. This has to stop.  

Our patients deserve better. We absolutely cannot afford to be working under the same pressures this year or next.

We recognise Government and the NHS are seeking to make headway on urgent and emergency care ahead of next winter and welcome the inclusion of some solutions focused on children. 

It is useful to see for example further support to ensure patients to get the right information at the right time. For young people and their families timely support makes a huge difference to their whole experience of care. As a College, we encourage our members to consider roles in NHS111 Paediatric Clinical Assessment services, where we have already seen encouraging results from this innovative new model of care. 

For any plan to be a success, delivery is key - and this new blueprint will need to be accompanied by a workable implementation plan and backed up by appropriate funding for children’s services, that integrated care boards can take forward with local partners.

Children cannot be an afterthought. We recognise that the focus of the recovery plan is largely on the frail and elderly but we continue to call for a child health and wellbeing strategy, that will be cross-departmental in approach. 

For paediatric care, focused investment is required, and measures that emphasise improving the quality and access of urgent and emergency care for children and young people will be critical, alongside real investment in the paediatric urgent and emergency care workforce. As such – we call on the DHSC and NHS England to publish their multi-year workforce plan at the same time.  Paediatricians stand ready to play their role in taking this crucial work forwards but our workforce must be invested in.