Nineteen hospitals targeted for ‘urgent support’ before winter

NHS England has told HSJ it will provide “targeted clinically led support” to “19 of the most pressured hospital sites across the country” in a bid to reduce long accident and emergency waits and avoidable admissions.

Senior teams from NHSE’s Getting it Right First Time and Emergency Care Improvement Support Team will visit the hospitals two to three days per week from September to December, with “virtual support outside of this”.

The “targeted support” will be aligned with NHSE’s existing emergency care intervention regime, which ranks systems requiring the most support in “tier 1” to those needing the least, in ‘tier 3’. NHSE has recently updated its tiering, which has meant an escalation in intervention for a number of systems (see more details below).

The 19 sites were selected after NHSE reviewed all acute hospitals to identify areas for urgent improvement before winter in relation to access, and in particular quality and patient experience. HSJ understands no new money is backing up these “improvement offers”.

Four of the 19 hospitals are in one ICS – Cheshire and Merseyside – which was already in the most intensive “tier 1” scrutiny and intervention from NHSE.

See the full list below.

The sites will be required to work on a minimum of two of six “rapid improvement journeys” – which either focus on admissions avoidance, reducing activity in the emergency departments, or improving in-hospital flow.

The “journeys” include a focus on “streaming” more patients to services such as urgent treatment centres, using same day emergency care and virtual wards to provide alternatives to admission, and measures to reduce inpatients’ lengths of stay.

Sarah-Jane Marsh, national director for urgent and emergency care, told HSJ: “We know this winter is going to be challenging and that there is much further to go to improve the experience for patients, which is why this extra support – including dedicated on-site clinical and operational expertise, and a personalised improvement plan based on best practice – will help us reduce avoidable admissions, long waits and stays in hospitals and put us in the best possible position to meet the needs of local populations.”

Tiering update

Following a review in July, NHS England has escalated its intervention in five integrated care systems following a deterioration in emergency care performance, and stepped it down in three other systems.

The ‘tier’ groups – from the highest, 1, to the lowest, 3, are based on performance against key metrics such as response times for category two ambulances and the four-hour accident and emergency target.

The full list is below.