Source · Select Committees · Public Accounts Committee
Recommendation 14
14
Accepted
Significant, persistent regional variations in patient experience and service performance across NHS.
Conclusion
We and past Committees have repeatedly expressed concerns about variations in patients’ experience of health and care.32 The C&AG’s report highlighted considerable differences in both service performance and access across geographical areas and providers. Proportions of the most serious A&E patients waiting less than four hours in March 2023 ranged from 53.3% in the Midlands to 62.1% in the South-East.33 We asked, for example, about the average length of discharge delays in Gloucestershire which is double the national figure. NHS England acknowledged that Gloucestershire is one of the areas it worked most closely with in an attempt to tackle systemic issues, but that similar problems will be replicated across the country.34
Government Response Summary
The government agrees with the committee's finding and states NHS England is actively working on improving and standardising UEC processes, providing targeted support to challenged systems. NHS England will write to the Committee in February 2024 to detail the underlying causes of variation.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation. Target implementation date: February 2024 3.2 NHS England is working to tackle unwarranted variation in performance. Making improvements to Emergency Departments and ambulance performance requires working between secondary, primary, community and social care so the Urgent and Emergency Care (UEC) tiering support offer is taking place at system level to ensure a whole-system approach. 3.3 The UEC recovery plan aims to improve and standardise processes to reduce unwarranted variation in the in-hospital UEC pathway. Specifically, NHS England is working with systems to improve their UEC performance through standardising service in the first 72 hours of care, increasing direct referrals to specialist care and Same Day Emergency Care (SDEC,) including paediatric SDEC, with focus on equitable access and consistency of delivery. 3.4 NHS England’s approach will focus on providing maximum support to the most challenged systems, bringing in national experts, NHS England’s Emergency Care Improvement Team and a range of supporters from best practice organisations. A bespoke offer is provided to each system, helping them align their plans to ensure delivery of local UEC recovery. There has been significant improvement in emergency performance over 2023-24 compared to last year, and there is already evidence of these improvements in emergency performance being fastest in some of the most challenged. 3.5 NHS England will write to the Committee in February 2024 setting out the underlying causes of variation in performance as more information will be available at this time.