Source · Select Committees · Public Accounts Committee
Recommendation 17
17
Accepted
Rollout of electronic patient management systems faces significant dependency challenges.
Conclusion
NHS England described several different initiatives that it had piloted to improve services, for example around electronic patient records and workforce flexibility measures.41 It also informed us that it had recently launched a new programme of work 32 Committee of Public Accounts, NHS ambulance services, Sixty-second report of Session 2016–17, HC 1035, 27 April 2017; Committee of Public Accounts, NHS continuing healthcare funding, Thirteenth report of Session 2017–19, HC 455, 17 January 2018 33 C&AG’s report, para 11 34 Q 57 35 C&AG’s report, para 11 36 Qq 63, 64 37 Q 71 38 Qq 52, 84 39 Q 66 40 Qq 49, 65, 124, 125 41 Q 47–48, 88–91 12 Access to urgent and emergency care specifically to identify variation and provide tools to make improvements.42 NHS England pointed to examples where NHS bodies were trying new approaches and identifying good practice, although cautioned that there were limits to the extent and pace at which these could be rolled out more widely.43 NHS England told us, for example, that there are four places with first-class electronic bed management systems providing information needed to manage patient flows in real-time.44 We asked why similar systems would be rolled out to only 16 more trusts by the end of the year. NHS England noted that there were several dependencies beyond the core technology, such as the availability of expertise and differing levels of organisational maturity within systems, that made this challenging and said it felt 16 trusts was the right number to focus on for the current phase.45 Delayed discharges
Government Response Summary
The government agrees with the committee's observation, stating that NHS England is actively working to tackle unwarranted variation in performance through the UEC recovery plan. They commit to writing 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.