The NHS Commissioning Board today announces that it is to review the model of urgent and emergency services in England.

The review, led by Medical Director Sir Bruce Keogh, will set out proposals for the best way of organising care to meet the needs of patients.

The review team will work with clinical commissioning groups (CCGs) to develop a national framework offer to help them ensure high-quality, consistent standards of care across the country.

Sir Bruce said: “The NHS is there for all of us and should offer appropriate, effective and rapid care whenever and wherever it is needed.

“Treatments for many common conditions such as heart attacks and strokes have evolved considerably over the last decade and are now best treated in specialist centres.  Yet we know people want their A&E nearby.

“This makes me think we need to review the increasingly complex and fragmented system of urgent and emergency care, so that sick, anxious and often frightened people can get what they need when they need it.”

The NHS Commissioning Board stresses that local commissioning will be at the heart of this review, which follows the Board’s commitment in its recent planning guidance.

It aims to enable CCGs to shape services for the future and put in place arrangements that meet the needs of patients.  It says it will work closely with CCGs to ensure the views of all those with an interest are taken into account.

It plans to publish emerging principles for consultation in the Spring.

In its planning guidance, published late last year, the NHS Commissioning Board said it would review urgent and emergency care as part of plans for more seven-day services.

As well as seven-day working, the review aims to help CCGs find the right balance between providing excellent clinical care in serious complex emergencies and maintaining or improving local access to services for less serious problems.

It will set out the different levels and definitions of emergency care.  These range from top-level trauma centres at major hospitals to local accident and emergency departments and facilities providing access to expert nurses and GPs for the treatment of more routine but urgent health problems.

As well as looking at how emergency care is provided, the review will also assess transfer processes between these levels of emergency care.

The NHS Commissioning Board also says it wants to improve public understanding of the best place to go for care. By helping the public to go to the right place first, both they – and those who have very serious illnesses and injuries – will be seen more quickly by specialist clinical teams with the right qualifications and facilities.

The NHS Commissioning Board adds that the review will take account of the way that emergency care in England works with other areas of the NHS, such as GP surgeries, community care, and the 24-hour NHS 111 advice line.

It stresses that the pattern of urgent and emergency care, including the number and location of services, will continue to be de developed locally to meet the different needs of urban and rural communities. The review aims to provide a national framework so high quality, consistent standards are offered across the country.

In future, planning reconfigurations should take account of the review’s conclusions, the emerging evidence and the national framework.

The review’s terms of reference will be published shortly.

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