The UK Government has pledged nearly £450m in its new Urgent and Emergency Care Plan 2025/26 (UEC plan), to address longstanding pressures across the NHS by reducing hospital admissions and lengthy discharge, tackling ambulance handover delays and eliminating corridor care.
Ahead of the anticipated publication of the new NHS 10-Year Health Plan, the UEC plan emphasises shifting patient care into more appropriate settings. This is part of the commitment to move from hospital to community under the Government’s Plan for Change to rebuild the NHS.
This will include around 40 new same day emergency care and urgent treatment centres, and up to 15 mental health crisis assessment centres, as well as new ambulances.
Urgent and emergency care where patients need it
Launching the plan on 6 June, the Department of Health and Social Care and NHS England said these investments and reforms will result in 800,000 fewer patients each year having to wait more than four hours at emergency departments (EDs), with more receiving urgent treatment in their community.
Announcing the UEC plan, health secretary Wes Streeting said: ‘Far too many patients are ending up in A&E who don’t need or want to be there, because there isn’t anywhere else available. The package of investment and reforms will help the NHS treat more patients in the community, so they don’t end up stuck on trolleys in A&E.
‘Hundreds of new ambulances will help cut the unacceptably long waiting times we’ve seen in recent years. And new centres for patients going through a mental health crisis will provide better care and keep them out of A&E departments, which are not well equipped to care for them.’
Chief executive of NHS Providers, Daniel Elkeles, said ‘there is a lot to like’ in the plan and welcomed its inclusion of ‘so many parts of the system, including primary, community and mental health care, in addition to ambulance and hospital services’.
‘It’s helpful that we’re seeing it in early summer, with time to ensure meaningful measures are in place ahead of the added pressures of winter,’ he said. ‘The extra capital investment for same day emergency care and mental health crisis assessment centres and ambulance services is particularly welcome.’
Shorter waiting times for urgent and emergency care
The plan’s publication follows the finding of the National Centre for Social Research’s British Attitudes Survey, published in April by The King’s Fund and Nuffield Trust, which revealed that 69% of respondents were very or quite dissatisfied with the length of time it took to be seen in A&E.
An Ipsos Mori survey from February also revealed 80% of respondents would avoid attending an A&E because of concerns over lengthy waits on trollies in corridors.
The Government has said the new UEC package ‘will improve patients’ experiences this year’, including ensuring at least 78% of A&E attendees are admitted, transferred or discharged within four hours, up from the current 75%.
The plan also puts a strong emphasis on ending 12-hour waits and corridor care, with the aim that fewer than 10% of patients experience such delays, and on expediting discharge for those medically fit to leave, targeting the nearly 30,000 patients a year who currently stay three weeks beyond their discharge-ready date.
A commitment to publish ED performance data from each individual hospital in England is also promised – something the Royal College of Emergency Medicine’s (RCEM) has been pushing for, and says it welcomes. However, the RCEM has since expressed concerns about ‘the lack of a cast-iron commitment to ending dangerous and demeaning 12-hour waits in Emergency Departments’.
A lack of ambition?
‘We have been awaiting this plan since January, and we are pleased to see its publication as the sooner we get on with addressing the issues which manifest themselves in the corridors and carparks of our A&Es the better’, said RCEM president, Dr Adrian Boyle.
‘However, some parts lack ambition – for example accepting that 10% of people will face A&E waits of more than 12 hours, when no patient should. Also maintaining the four-hour standard at 78% when the stated aim is that 95% of patients should move through the ED within this time – something which hasn’t happened for a decade.’
The Royal College of Physicians (RCP) has long called for an end to corridor care, with president Dr Mumtaz Patel calling for NHS England to publish the data it promised on the prevalence of corridor care ‘as a priority’.
‘It will set a baseline to determine whether measures set out in this plan, such as improving the timeliness of discharge and use of urgent treatment centres, are working,’ he said. ‘Success will depend on long-term investment in staffing, better integration between hospital, community and social care, and a stronger focus on the needs of older patients and those living with frailty.’
Ambulance handover targets
Another of the UEC plan’s headline targets includes reducing ambulance wait times for Category 2 calls by over 14%, meeting a new maximum 45-minute ambulance handover standard. A commitment to roll out almost 500 new ambulances across the country by March 2026 has also been promised.
The plan also mandates closer collaboration with community and ambulance services, with ambulance services set to benefit from expanded access to patient records to reduce handover delays, freeing up capacity and positively impacting hospital admissions.
However, Dr Boyle said the RCEM has ‘concerns about how the maximum 45-minute ambulance handover will be achieved without exposing patients to risk and increasing overcrowding in our departments’.
The RCEM ‘will be pushing to ensure that the new so called “Mental Health A&Es” and new same day emergency care services are co-located with existing Emergency Departments’, he added.
Frontline consequences for urgent and emergency care
Hospital staff will be central to delivering these improvements, with a system-wide expectation of shared leadership and accountability for urgent and emergency care performance.
NHS national director for urgent and emergency care, Sarah-Jane Marsh, said: ‘While the 10 Year Health Plan will set out a longer-term vision to transform urgent and emergency services for the 21st century, there is so much more we could all be doing now.
‘This plan sets out not only what we know is working across the country, but how systems must work together to improve access and quality for the benefit of our patients. In order to support this shift in delivery focus, NHS England will be asking providers and systems to be accountable to their own local boards and populations, creating robust winter plans which will be tested during winter exercises throughout September.’
NHS Providers is optimistic that the plan ‘should result in meaningful progress compared to last winter’.
Building workforce capacity will be key
Despite these reassurances, Dr Simon Walsh, British Medical Association (BMA) consultants committee deputy chair and emergency medicine consultant, said this long-promised plan will leave doctors working in EDs and other acute specialties ‘severely underwhelmed’.
‘There is a clear need to increase capacity within acute hospitals to improve patient flow and shorten waits – but the plan does not set out how acute trusts will improve this,’ said Dr Walsh. ‘In reality, beds need staff, and the lack of any plan to retain doctors and therefore to stop persistent rota gaps is a huge oversight.’
Dr Walsh also criticised the proposed mental health assessment centres provision, adding that the BMA has ‘concerns about separating out mental and physical healthcare when the two are so linked’ and that ‘investment in the community is desperately needed’.
In addition, he called the detail on social care ‘woefully inadequate’, concluding that ‘anyone hoping for a radical plan to fix the crisis engulfing emergency care will be bitterly disappointed’, and ‘staff who are battling against impossible circumstances will not feel assured that this plan will deliver.’
The RCP echoes the concerns over capacity and has urged the Government to ensure ‘ongoing engagement with the royal colleges and specialist societies’ to support the success of the plan. And it highlighted that ‘its success will depend on adequate staffing, additional leadership capacity, and investment in IT systems and estate infrastructure.’
