Urgent and emergency care is the range of healthcare services available to people who need medical advice, diagnosis and/or treatment quickly and unexpectedly.
The Government’s vision for urgent and emergency care is of universal access to high quality urgent and emergency care services 24/7, so that whatever your need, whatever your location you get the best care, from the best person, in the best place at the best time. To deliver this the Department of Health is working on a number of initiatives. These all support the Quality, Innovation, Productivity and Prevention (QIPP) programme’s workstream on urgent and emergency care
The clinical quality indicators for A&E and ambulance services were officially launched with the publication of the guidance document and data definitions. These have been developed by Professor Matthew Cooke, National Clinical Director for Urgent and Emergency Care, working with the College of Emergency Medicine, the Royal College of Nursing and lay representatives, and will balance timeliness of care with other indicators of quality, including clinical outcomes and patient experience.
In June 2009, the Care Quality Commission (CQC) began an investigation into the provision of out-of-hours primary care services in five PCTs by Take Care Now. The CQC’s enquiry was prompted by the tragic death of Mr David Gray from Cambridgeshire in February 2008 after he was administered 100mg of diamorphine by a locum doctor from Germany. The report makes a number of recommendations for commissioners and providers of out-of-hours Services. In response, David Nicholson, NHS Chief Executive, wrote to chief executives of Strategic Health Authorities and Primary Care Trusts. His letter provides the Department's response to the report and brings the CQC's recommendations to Chief Executives’ attention.
On 21 June 2010 the Secretary of State wrote to John Heyworth, President of the College of Emergency Medicine to explain the changes.
As set out in Equity and excellence: liberating the NHS, the Government is committed to developing a coherent 24/7 urgent care service in every area of England that makes sense to patients when they have to make choices about their care.
To help deliver this a new NHS 111 telephone number is being piloted. This will provide people with a single point of access for all non-emergency NHS healthcare services. The first pilots of this new service were launched in August 2010 in County Durham and Darlington and in November 2010 in Nottingham City and Lincolnshire.
The Government proposes to put GPs in charge of commissioning urgent and emergency care. The Government believes that empowering GPs and other health professionals will achieve better and more patient-focussed services.
Equity and excellence: liberating the NHS proposes to hold the NHS to account against clinically credible and evidence-based outcome measures, not process targets, and to remove targets with no clinical justification. The first sets of clinical quality indicators, for A&E and ambulance services, were announced on 17 December 2010 and will start being used from April 2011. In the meantime existing standards continue to apply.
The period until April 2012 will be one of transition. During this time, some existing requirements and guidance will remain in place. Most of these are focused on individual types of service. Details of these can be found via the links below:
Urgent and Emergency Care Policy Team, New King’s Beam House, 22 Upper Ground, London SE1 9BW