The government wants to expand urgent and emergency care facilities, but the response from doctors and nurses is muted. 

The British government has pledged almost £450 million investment to expand urgent and emergency care facilities to provide faster care for patients. 

What is called the urgent and emergency care plan, hopes to deliver around 40 new same-day emergency care and urgent treatment centres – which treat and discharge patients in the same day, avoiding unnecessary admissions to hospital; up to 15 mental health crisis assessment centres to provide care for patients and avoid them waiting in A&E for hours for care; and almost 500 new ambulances. 

“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,” said Wes Streeting, health and social care secretary of state. 

The plan’s emphasis is on shifting more patient care into more appropriate care settings. 

Every day, more than 140,000 people access urgent and emergency care services across England. From 2010 to 2011, demand has almost doubled, with ambulance service usage rising by 61%. A&E waiting time standards have not been met for over a decade, while the 18-minute target for category 2 ambulance calls has never been hit outside the pandemic.

“There is a lot to like about this plan. 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,” said Daniel Elkeles, chief executive of NHS Providers. 

A more muted response

The response to the plans from doctors and nurses was more muted. 

Simon Walsh, BMA consultants committee deputy chair and emergency medicine consultant, said that the long-promised plan would leave doctors working in emergency departments and other acute specialities “severely underwhelmed”.

He said that the emphasis on preventing the need for patients to visit A&E is of course right, but said that there was little to nothing on improving the experience for those who do find themselves there. At the same time, he highlighted that the plan does not set out how Trusts can increase capacity within acute hospitals to improve patient flow and shorten waits.

The Royal College of Nursing’s general secretary and chief executive Nicola Ranger was similarly blunt. 

“This is a plan high in ambition, but low on detail of how the nursing staff needed to make this work will be supported to deliver these changes,” she said, adding that nothing can be achieved “unless there is a commitment to invest in an overworked and understaffed nursing workforce”.