The NHS will open 40 new “mini A&Es” at hospitals across England in a bid to treat hundreds of thousands more patients within four hours.
The same-day emergency care and urgent treatment centres (UTC) – which treat and discharge patients in the same day – are part of plans to free up hospital beds for patients in serious emergencies.
There are already some in existence in England, usually located next to A&E, where 95 per cent of patients are seen within four hours.
Patients will be directed to either a UTC or a hospital by 999 call handlers, or taken there by ambulances. A child injured after falling off a skateboard would be one example of a case directed to a mini A&E.
While in opposition, Wes Streeting visited a UTC in Sydney after they were introduced by the Australian government, and was “convinced this was the way to go” for the NHS, a source close to the Health Secretary said.
The location of the 40 new urgent treatment centres will be decided by the Department of Health after NHS trusts bid for them, it is understood.
Ministers promise 800,000 fewer people will have to wait more than four hours in emergency departments from this December under the Urgent and Emergency Care Plan for England.
The £450m plan contains a range of pledges and ambitions aimed at avoiding another winter A&E crisis which last year saw corridor care become endemic as clinicians battled a quad-demic of viruses.
A key focus is on caring for people closer to their homes and “improving flow through hospitals” to avoid patients waiting over 12 hours to be seen and “making progress on eliminating corridor care”.
League tables are being introduced for emergency departments – something the Royal College of Emergency Medicine (RCEM) had been calling for – to improve persistently failing trusts and drive up performance. Ambulance waiting times for category 2 patients – such as those suffering stroke, heart attack, sepsis or major trauma – will be cut by more than 14 per cent, from 35 to 30 minutes. A previous target of 18 minutes has been repeatedly missed. A maximum 45-minute target for patients to be handed over to A&E has been set, to “eradicate” ambulance queues outside hospitals and “get 550,000 more ambulances back on the road for patients”. 500 new ambulances will also be rolled out across the country by March 2026. 15 mental health crisis assessment centres, designed to ensure mentally ill people do not have to wait in A&E for hours, will open across England to offer 24/7 care.Ministers say the four-hour target to be admitted, transferred or discharged will apply to a minimum of 78 per cent of patients who attend A&E, up from the current 75 per cent. There will also be a focus on seeing more children.
The Government wants to slash the number of patients waiting more than 12 hours for a hospital bed – or to be discharged from A&E – so this occurs “less than 10 per cent of the time”. Around 1.7 million attendances at A&E every year currently exceed this time frame.
The Royal College of Emergency Medicine said the target lacked “ambition” because it accepts that people will face A&E waits of more than 12 hours, “when no patient should”.
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Streeting said: “No patient should ever be left waiting for hours in hospital corridors or for an ambulance which ought to arrive in minutes.
“We can’t fix more than a decade of underinvestment and neglect overnight. But through the measures we’re setting out today, we will deliver faster and more convenient care for patients in emergencies.
“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.
“Because patients can’t get a GP appointment, which costs the NHS £40, they end up in A&E, which costs around £400 – worse for patients and more expensive for the taxpayer.”
Under the plans, paramedics will play a bigger role in the community, with patients given “more effective treatment at the scene of an accident or in their own homes from ambulance crews”.
More patients will also be seen by urgent community response teams in their own homes to try to avoid hospital admission.
The NHS is also pledging better use of virtual wards, where patients are monitored by hospital staff from their home, and there are plans to drive up vaccination rates among NHS staff to help protect patients.
How doctors have reacted
RCEM president Dr Adrian Boyle said the plan was the first acknowledgement by the NHS of the “shameful situation being experienced by patients and clinicians across the country’s emergency departments”.
But he raised concerns about how the maximum 45-minute ambulance handover will be achieved “without exposing patients to risk and increasing overcrowding in our departments”.
The Royal College of Physicians 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”.
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