Get back on track with access standards for A&E and ambulance waits.

Remit: Get back on track with access standards for A&E and ambulance waits, ensuring more than 95 percent of patients wait no more than four hours in A&E, and that all ambulance trusts respond to 75 percent of Category A calls within eight minutes; including through making progress in implementing the urgent and emergency care review and associated ambulance standard pilots.

A key focus for the NIHR CLAHRC YH Avoiding Attendances and Admission Theme is to analyse emergency and urgent care data from the time of call through to discharge from hospital, to answer key UK policy priorities such as ‘Delivering the Forward View’.   Analysis of our linked datasets will identify those patients accessing ambulance services who are amenable to alternative care pathways, thereby reducing unnecessary conveyance to hospital and thus improving response times for more serious cases.  

Preliminary analysis has identified mental health patients as a group amenable to alternative care and mental health nurse triage delivered from the emergency call room is an intervention being evaluated for this patient group.  In addition, analysis is underway of Hospital Episode Statistics Data to examine patterns of demand for A&E services and the impact on the four hour performance target.  Initially the theme is defining unnecessary A&E attendances, their impact on A&E performance and the potential for intervention for these attendances to improve performance and reduce crowding.