The government and the NHS have now published a new blueprint in an attempt to help recover urgent and emergency care services, reduce waiting times and improve the overall patient experience. However, Stephen Barclay, the Health Secretary admitted that there was no quick fix for the very serious pressures facing the NHS and social care.
Rishi Sunak claimed at the launch of this plan that it will deliver “the largest and fastest ever improvement in emergency waiting times in the NHS’s history.”
The plan significantly increases frontline capacity with a further 800 new ambulances, including 100 specialist mental health vehicles and 5,000 more sustainable hospital beds with all of this backed by a £1billion dedicated fund. Additionally, same-day emergency care units staffed by consultants and nurses will open in every hospital with a major A & E department.
Freeing up space in hospitals and speeding up discharge for those who are medically fit to leave are key parts of the blueprint, which will see pilots of new approaches to NHS step down care across the country where patients will receive rehabilitation and physiotherapy at home. The scheme will ensure that people have a smooth transition out of hospital, thus reducing the chances of readmission and with the great aim of potentially reducing the long-term dependence on social care.
The aim is that by March 2024, 76% of A & E patients will be seen within 4 hours. The official target is 95%, but is currently fewer that 70% are seen within that timeframe.
During 2023/24, the target is to reach a 30-minute average response time for category 2 emergency calls, such as heart attacks and strokes. In December 2022 patients waited over 90 minutes, whilst the official target was 18 minutes.
A key element of this strategy is to expand urgent care in the community, thus keeping people away from hospitals and seeing them treated in their own homes.
This will in part be achieved through the expansion of ‘virtual wards’ whereby patients can receive expert care in their own homes via digital technologies. The aim of the virtual wards is to support the most elderly patients, as well as those with respiratory and heart conditions in their own homes rather than in hospital. Doctors and other health staff review their cases each day and patients using wearable devices can report daily readings and results so they can be monitored remotely. Patients can then receive home visits where necessary. The target is to support up to 50,000 patients per month this way, up from around 10,000 at the end of 2022.
Stephen Barclay stated “… up to 20% of hospital admissions are avoidable with the care in the right place. This includes rolling out more services to help with falls and frailty, as well as supporting patients to recover in the comfort of their own homes. Not only will patients benefit from better experiences and outcomes, it will ease pressure on our busy emergency departments.”
James Jamieson, Chairman of the Local Government Association said “we are pleased to see the focus on expanding community health and care services and the recognition of the importance of therapy and recovery support to get people back home following discharge. Collaboration and a focus on outcomes will be key to the successful delivery of the plan.”
However, for all of this to have a chance of working the outstanding issues of acute staff shortages in the NHS and social care sector and the ongoing NHS infrastructure funding need must be grappled with as a priority. The long-term workforce plan for the NHS will be the defining document with efforts to expand the number of emergency medical technicians, alongside a greater use of students and apprentice paramedics, as well as training more staff in mental health will be key priorities.
This plan has been met with widespread approval and support from the professional bodies associated with the NHS.
Professor Adam Gordon, President of the British Geriatrics Society noted “Many people, especially older people with frailty and complex conditions, are facing long waits in emergency departments and on wards before being discharged from hospital.
We are at the British Geriatrics Society are pleased to support NHS England’s ‘Urgent and emergency Care Recovery Plan’ which addresses system-wide issues that go far beyond the hospital front door. The emphasis on care closer to home, alternatives to hospital admission, rehabilitation and person -centred care is very welcome.
With the right funding, workforce and clinical leadership, it should make a real difference for users of health services and start to make inroads on the delays and shortages that prevent timely discharge and community -based support for rehabilitation and recovery.”As with any plan, the implementation and results will be what really matters and only time will tell whether this plan has achieved its goals.
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