NHS England speeds up emergency care transformation plan

A new payment system for urgent and emergency care will be trialled “later this year”, in partnership with Monitor, as part of its business plan for 2015-16.

HSJ understands this trial was originally scheduled to start next month. However, a spokeswoman for NHS England said the trial was on track.

The national commissioning body plans for all areas to be able to use the new payment system “in shadow form” by 2016.

It has sped up bringing in the changes to urgent and emergency care services because of the struggling performance of many accident and emergency departments this winter.

The sector failed to meet the target throughout last year for 95 per cent of patients to be seen, treated, admitted or discharged within four hours.

Urgent and emergency care networks will be developed across the country to support the introduction of the new care models in the NHS Five Year Forward View and “increase system-wide integration”. NHS England will produce standards that these networks should meet.

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The plan says: “Whilst the urgent and emergency care review’s vision has set in place a long term plan for transformational change in the urgent and emergency care system, it is clear that we cannot go into next winter without significant change. This is why we will accelerate the delivery of a number of processes that form a key part of this vision.”

This accelerated work will include encouraging ambulance services to treat more patients at the scene to avoid unnecessary admissions.

Patient referral pathways will also be looked at in an attempt to improve the flow of patients through the system.

A “critical” piece of work will establish an “enhanced” out of hospital service that ties together NHS 111, out of hours and in-hours general practice, community services, rehabilitation services and the independent and voluntary sectors. This will be expected to link “seamlessly” with social care “to tackle unnecessary admissions and delayed discharges”.

NHS England also aims to have “complete information sharing” across NHS 111, 999 and hospital admissions areas “to at least a minimum of summary care record” including end of life and advanced care plans, by March next year.

It will also review the “uptake and impact” of patient choice in physical and mental health by the end of the year.

The NHS 111 commissioning standards will be revised by September. NHS England will look at how to integrate 111 with out of hours services.

There will be a drive to improve waiting times in elective care, with a focus on groups of patients who are “particularly poorly served”. This includes older people and people with mental health problems or learning disabilities.

The elective intensive support team will be sent to help clinical commissioning groups and providers “to reduce variation and improve waiting list management”.

NHS England will establish a new framework for making investment decisions on specialised services.

By December a second wave of NHS genomic medicine centres will have been designated, and by March 2016 £10m in capital funding will have been awarded to the first and second wave.