Urgent and emergency care five-year strategy 2024-2029

Urgent and emergency care services are a  fundamental part of our health and care system. They are there to respond when we have an accident or become unwell and need urgent attention from health and care professionals.

These services are under enormous pressure which has been increasing year on year. Demand for urgent and emergency care is rising as more people are living with long term physical and mental health conditions. Nationally, and in Lancashire and South Cumbria, hospitals are busier than before the COVID-19 pandemic. We are seeing long delays for people, including those who are waiting for ambulances and those in hospital beds waiting to be discharged. This means that we are not delivering the best quality of care, experience, and outcomes as we would like. In Lancashire and South Cumbria, we also have significant financial challenges as we are spending more on healthcare than our budget allows. Therefore, we need to reduce spend across our system yet continue to make our services more efficient and effective for the benefits of our population and staff.

However, we are seeing innovation across the NHS in England which is changing the way we work as an entire health and care system: organisations are working more collaboratively together, we are seeking to integrate services across health and social care, we are embracing digital advances and new technologies and we are focusing more on delivering care in the community that is proactive, high quality, and closer to home.

Improving urgent and emergency care is a priority for our system and for the NHS nationally. This is reconfirmed by guidance and strategic planning from NHS England – most recently, the NHS 2024/25 priorities and operational planning guidance and the NHS Urgent and emergency care recovery plan year 2. We are embracing changes, responding to their direction, and working to achieve the national commitment to improve waiting times and patient experience. In 2023/24, we successfully achieved the national target to improve Emergency Department (ED) performance (76% of people seen within 4 hours by March 2024) and ambulance response times (26 minutes ‘category 2’ non-life-threatening emergency calls within the target of 30 minutes). However, we cannot stand still. This year’s national targets are higher and systems are asked to focus on maintaining the expansion of capacity delivered during 2023/24, increasing productivity, improving clinical outcomes and continuing to develop services which shift activity away from acute hospitals for people with unplanned care needs. As a system, we recognise that performance in relation to urgent and emergency care needs to further improve going forwards and we are committed to making this happen for the benefit of our population.

The purpose of this strategy is to guide how we transform our urgent and emergency care services, both clinical and non-clinical, over the next five years to enable people to easily access the right care and support which meets their needs. It describes our challenges and the opportunities for the future; it sets out our vision and priorities. Core to this strategy are - transforming services in the community to deliver urgent care closer to home; eliminating variation in service in different parts of Lancashire and South Cumbria; making sure that services have the right capacity to meet the needs of our population; ensuring our services are fit for the future.

This strategy has been produced by Lancashire and South Cumbria system-wide partners, including acute Trusts, local authorities, North West Ambulance Service, mental health, primary and community care, voluntary and community, faith and social enterprise sector, place-based partners and the public.

While we recognise that the formation of our integrated care system is still in its early stages and evolving, working in partnership at place and system is integral to change the way we deliver urgent and emergency care for the better. Our four place-based partnerships will lead the delivery of this strategy so they can meet the needs of their local communities. They will also collaborate so that everyone, no matter where they live in Lancashire and South Cumbria, will have access to the same standard of high quality, safe and timely urgent and emergency care.

We recognise the enormity of the ambitions we are describing but we want to be bold and aim high to improve services for our population. By working together, we can achieve our vision set out in this document.

Thank you to all partners who have supported the development and production of this strategy.

Jayne Mellor
Director of urgent, emergency and planned care
Lancashire and South Cumbria ICB

Scott McLean
Chief Operating Officer
University Hospitals of Morecambe Bay NHS Foundation Trust

Co-chairs of Lancashire and South Cumbria Urgent and Emergency Care Collaborative Improvement Board.