New measures to improve patient care ahead of winter

A&Es in 25 hospitals will receive a share of £150 million in funding to upgrade, reduce overcrowding and improve infection control ahead of winter

• NHS 111 piloted as ‘front door’ for urgent care so patients can access the right service and avoid unnecessary visits to emergency departments

• Consultation to launch on A&E performance measurements to ensure they reflect modern emergency care and deliver what patients need

A&Es in 25 hospitals across England will receive an additional £150 million to expand and upgrade, ensuring they have the physical space to treat patients, manage patient flow and improve infection control, the Health Secretary Matt Hancock has announced today.

This is in addition to the £300 million announced recently for 117 trusts to upgrade their facilities, meaning the government has now invested £450 million to upgrade A&Es this winter.

The funding will expand waiting areas and increase the number of treatment cubicles, helping boost A&E capacity by providing additional space and reducing overcrowding. Projects will be completed by the start of next year so hospitals benefit from the upgrades during the peak of winter.

Alongside this, a new offer to patients is being piloted in trusts across England, with NHS 111 being the first point of contact for accessing urgent medical care.

To ensure patients get the right care in the right place and avoid unnecessary visits to emergency departments, NHS 111 will build on its role during the pandemic to direct patients to the most clinically appropriate service, including emergency departments, an urgent treatment centre, a GP or mental health professional. Based on what works best during the pilots, this approach will be rolled out to all trusts from December this year.

Health and Social Care Secretary Matt Hancock said:

"We are investing £450 million to make sure our A&E departments are ready for winter. Hospitals around the country will be able to expand and upgrade to ensure they can continue safely treating patients in the coming months.

"During the peak of the pandemic we saw millions of people using NHS 111 to get the best possible advice on COVID-19, and other urgent NHS services. These pilots will build on this and test whether we can deliver quicker access to the right care, provide a better service for the public and ensure our dedicated NHS staff aren’t overwhelmed.

"We all need to play our part by washing our hands regularly, using a face covering and keeping our distance from those not in our household. We are determined to protect the NHS as we did during the peak."

NHS 111 will also book appointments for patients with the appropriate service to cut out unnecessary queueing and ensure they get the right care first time. This will be safer and more convenient for patients as it will reduce the amount of time spent in waiting rooms.

Those facing a life-threatening emergency should continue to dial 999 immediately. If someone is unsure how serious a condition is then NHS 111 can offer advice and if necessary, dispatch an ambulance. To support this expansion the NHS is investing £24 million to increase 111 call handling capacity and will have more clinicians on hand to provide expert advice and guidance.

Each year there are 14.4 million A&E attendances in England that arrive without referral by 111, a GP or in an ambulance, as well as 2.1 million attendances that don’t result in any admission or treatment. Reducing this unnecessary use of emergency departments will ease the pressure on the NHS this winter and reduce transmission of COVID-19.

Dr Cliff Mann, NHS National Clinical Director for Urgent and Emergency Care, said:

"While emergency admissions are now back to near normal levels and 999 calls are actually above usual, COVID-19 infection control means rethinking how we safely look after people who might previously have been to an emergency department for a more minor condition. Local teams are working hard to expand and adapt services to ensure people can continue to get the care they need safely, whether that’s in hospital or closer to home.

"This additional investment will help us continue the development of NHS 111 and provide a broader range of services, with direct booking that will ensure all patients can see the right clinicians in the right setting, and address the extra challenges posed by COVID-19 so that emergency departments can safely treat those patients who do require their services."

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

"Expansion of NHS 111 will help patients to be seen more quickly by the service most appropriate to their needs. We are pleased to have reached the consultation phase of how A&E performance is measured with a focus on the safe, timely care of the very sickest patients, and look forward to the publication of the proposals.

"A further boost to capital funding to help redevelop our most challenged emergency departments is very welcome and vital to help ensure social distancing and reduce the spread of infection. Crowding must be eliminated from emergency departments – now more than ever – and this is a helpful step towards tackling that problem."

The pandemic has shown NHS 111 can play a more prominent role in triaging patients to make sure they get the right care, first time round.

As winter approaches and we continue to tackle the COVID-19 pandemic, these additional measures will help to reduce overcrowding in A&E, protecting both staff and patients and making the NHS as safe as possible.

If a patient without a life-threatening condition in the pilot areas arrives at an A&E department without contacting NHS 111, they will continue to be given the assistance they need, but may end up waiting longer than patients with similar health issues who booked an appointment through NHS 111.

A public communications campaign ‘Help Us Help You’ will also launch later this year to direct people to the right NHS service.

Alongside this, NHS England has been exploring whether improvements could be made to emergency care performance measures as part of its ongoing clinically-led review, which has also considered how to accurately measure performance while the service meets the continuing challenges of COVID-19.

Before December, a consultation will be launched on standards to ensure they reflect modern emergency care and deliver what patients need. The existing standards remain in place and – if any updates are subsequently made – this will only be on the basis of strong evidence and after thorough consultation.

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