ICSs most ‘off target’ on recovery named by NHS England

NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan.

The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance.

The seven “first tier” systems are: Cheshire and Merseyside; Cornwall and the Isles of Scilly; Devon; Greater Manchester; Kent and Medway; Norfolk and Waveney; and North East London ICS. The only ambulance trust in the first tier is South Western Ambulance Service Foundation Trust.

Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”.

A further seven systems and two ambulance trusts have been placed in the secondary tier.

These organisations are deemed “largely on track” on delivery against the UEC plan, but will receive support from NHSE’s regional teams to “deep dives to diagnose challenges and drive improvement”.

The second tier trusts are East Midlands Ambulance Service Trust and East of England Ambulance Service Trust. The second tier systems are Frimley; Hampshire and Isle of Wight; Herefordshire and Worcestershire; Hertfordshire and West Essex; Humber and North Yorkshire; Shropshire, Telford and Wrekin; Staffordshire and Stoke-on-Trent.

The groups are mainly based on performance against the four hours accident and emergency target and category two ambulance response times but 12-hour A&E waits and the proportion of beds occupied by patients with a length of stay of 14 days or more are also considered.

NHSE director of UEC tiering support Neill Moloney said there were “pockets of good practice” even in the organisations listed in the tiers.

He said: “We’ll be identifying a bespoke offer of support… We’re not looking to tick boxes. This is about delivering real improvements.

“There are organisations which have been in difficulty in some cases for some time. This is a two-year [recovery plan] and we will continue to support those organisations to recover their performance.”

NHSE is aiming to have identified the specific support needs for each system listed in the tiers by the end of June and will carry out quarterly reviews of the tiers, with the first review in September.

NHSE is also developing a third “universal” tier for all systems which will involve sharing best practice on emergency care performance.