Twenty-seven urgent and emergency care systems that are struggling to meet the four hour target will be given targeted support as part of a programme announced today.

The Emergency Care Improvement Programme (ECIP) has been set up by Monitor, the NHS Trust Development Authority, NHS England and the Department of Health.

It will particularly focus on the winter months and will help the struggling systems adopt “evidence based tried and trusted improvements that are proven to work”.

These include:

  • good consultant leadership in an emergency department to ensure patients enter and exit the department on a timely basis. Plymouth Hospitals Trust provides a strong example of how this can work well, according to the ECIP team.
  • early assessment and intervention for frail elderly patients by multidisciplinary teams and geriatricians to try and avoid admissions. University Hospitals of Leicester Trust is cited as a good example; and
  • ambulatory emergency care to avoid patients being admitted and instead transferred into more appropriate services. Ashford Hospital, run by East Kent Hospitals University Foundation Trust, is currently doing this well, according to the ECIP team.

A buddying system to pair strong performers with those that are struggling is part of ECIP’s work. A programme spokesman said the buddying system had not yet been worked out and would not be a “big part” of the programme.

Hospital door

Strong performers will be buddied with those that are struggling is part of ECIP’s work

No funding will be given to help these areas make improvements.

The ECIP work has been informed by a Monitor report, published this morning, which found some difficulties in accident and emergency resulted from issues in the wider health and social care system.

According to the research, 91 per cent of trusts failed to meet the four hour target last winter.

The sector has not met the target to see, treat, admit or discharge 95 per cent of patients within four hours for nearly two years.

In Monitor’s report it concluded that A&E departments had their worst winter in more than 10 years because of a high bed occupancy rate.

HSJ previously reported that the emergency care intensive support team would be expanded to help trusts that were struggling to see and treat 95 per cent of patients within four hours.

Vincent Connolly, ECIP clinical director, said: “ECIP was set up to help local systems provide safer care for patients by improving the urgent and emergency care system. This programme is about helping and supporting clinical colleagues and others to implement improvements we know can and do work across the country.

“Our challenge is to see real improvement in the four hour waiting time standard which, in turn, will have a positive effect on patient outcomes and experience. This will be the measure of success.”

The acute trusts in the 27 selected areas are:

  • Barts Health Trust
  • Brighton and Sussex University Hospitals Trust
  • Cambridge University Hospitals Foundation Trust
  • Colchester Hospital University Foundation Trust
  • East Kent Hospitals University Foundation Trust
  • Heart of England Foundation Trust
  • Hull and East Yorkshire Hospitals Trust
  • Kettering General Hospital Foundation Trust
  • King’s College Hospital Foundation Trust
  • Kingston Hospital Foundation Trust
  • London North West Healthcare Trust
  • Mid Essex Hospital Services Trust
  • Mid Yorkshire Hospitals Trust
  • North Cumbria University Hospitals Trust
  • Plymouth Hospitals Trust
  • Portsmouth Hospitals Trust
  • Royal Cornwall Hospitals Trust
  • Shrewsbury and Telford Hospital Trust
  • St George’s Healthcare Foundation Trust
  • University Hospitals Coventry and Warwickshire Trust
  • University Hospitals of North Midlands Trust
  • United Lincolnshire Hospitals Trust
  • West Hertfordshire Hospitals Trust
  • Weston Area Health Trust
  • Wirral University Teaching Hospital Foundation Trust
  • Worcestershire Acute Hospitals Trust
  • York Teaching Hospital Foundation Trust