Recommendation 17

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