Major plan to recover urgent and emergency care services

Medicine And Emergency Care

Over the winter period at SWB, we have experienced high levels of demand on our services, resulting in the declaration of three internal critical incidents, where additional resources and actions were utilised to de-escalate pressure in our emergency departments. This pressure is mirrored across the country; we’ve seen record demand for NHS services with the latest data showing more A&E attendances than ever before, growing numbers of the most serious ambulance call outs, and millions of NHS 111 calls a month over winter.

In January 2023, the NHS and the government published a new blueprint to help recover urgent and emergency care services, reduce waiting times, and improve patient experience.

Frontline capacity is due to be boosted further, thanks to 800 new ambulances (including 100 specialist mental health vehicles) and 5,000 more sustainable hospital beds, all backed by a fund of £1 billion.

As well as an expansion of urgent and emergency care provision, urgent community care will be expanded to ensure people can get the care they need at home, without the need for a hospital admission. These services, due to run for at least 12 hours a day, will respond to calls normally requiring an ambulance crew. This will enable injured people to receive care and treatment at home within two hours.

Same day emergency care units, staffed by consultants and nurses, will be open in every hospital with a major A&E, helping to transform patients’ experiences and allowing thousands of people each week to avoid an overnight hospital stay. We’ve recently highlighted the plans for SDEC at Midland Met, and the SDEC Unit recently moved to a new location at City Hospital to increase capacity. Plans are in place for a dedicated Modular SDEC Unit to improve our service offer at Sandwell General Hospital by the end of March 2023.

A key part of the plan is to speed up discharge for those who have no criteria to reside and free up bed space. To this end, we will see pilots of a new step-down care approach across the country, enabling patients to receive rehabilitation and physiotherapy at home. The scheme will ensure people have a smooth transition out of hospital, reducing the chances of re-admission while also potentially reducing long-term demand on social care.

The success of ‘virtual wards’, where patients receive high-tech care in their own home is set to grow; there are already 7,000 virtual ward beds in the community, and up to 50,000 patients a month are expected to benefit by the end of 2023/24. Within SWB, we’re projected to have 157 virtual beds by the end of March 2023, and we’ve seen great benefits to the programme thus far. Changes aimed at growing and supporting the workforce will give NHS colleagues greater flexibility, making it easier for them to move between hospitals and work in services like 111, with more work from home options for call handlers.

The number of emergency medical technicians will also be increased, providing another entry route to working in the NHS, alongside greater use of student and apprentice paramedics and further mental health training for colleagues.

The two-year plan aims to stabilise services to meet the NHS’s two major recovery ambitions: to help achieve a four-hour A&E performance of 76 per cent by March 2024 and to improve category two ambulance response times to an average of 30 minutes over the next year.

These ambitions represent one of the fastest and longest sustained improvements in emergency waiting times in the NHS’s history.