Department of Health and Social Care
Central Government
Action Planned
The Department of Health and Social Care acknowledge issues with handover of test results and emergency department pressures. They state that an ambulance data set is currently being rolled out across England to link patient data, and that the NHS is taking action to improve urgent and emergency care performance. (AI summary)
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Dear Mr Parsley,
Thank you for your report of 24 July regarding the death of Regan Edwin James Smith. I am replying as Minister with responsibility for urgent and emergency care.
Firstly, I would like to offer my sincere condolences to Mr Smith’s family and loved ones. It is vital that where Regulation 28 reports raise matters of concern, these are looked at carefully so that NHS care can be improved. I am grateful for you bringing these matters to my attention.
Your report raises concerns with an ineffective handover of test results between the ambulance service and the A&E staff at Ipswich Hospital, part of East Suffolk and North Essex NHS Foundation Trust (ESNEFT), as well as emergency department pressures. In preparing this response, Departmental officials have made enquiries with NHS England (NHSE) and East of England Ambulance Service NHS Trust (EEAST).
Regarding the formal clinical handover of patients, there are a number of protocols that should be followed. This includes standards set out by the General Medical Council on how patient information should be shared, and the NHS standard contract which sets out targets on handover delays. The responsibility for the implementation and oversight of protocols across England is at a local level. I understand that ESNEFT submitted evidence during the inquest which set out actions being taken locally to improve processes which you have considered and were content with. EEAST advise that in the East of England, all hospital A&Es have information systems to provide records of patients arriving by ambulance and that they are ensuring that ambulance patient care records are available as part of the assessment of patients who arrive at A&E by ambulance.
The rapid exchange of clinical information verbally remains an integral part of communication. However, work is ongoing with NHSE to provide IT support that can deliver improved sharing of electronic information across systems. Linking the ambulance computer aided despatch system and electronic patient record collected by ambulance services with emergency departments data will provide better information about the patient journey.
Further, to support learning and system improvement, an ambulance data set is also currently being rolled out across England. This will be achieved by linking patient data collected by ambulance services with data collected by emergency departments through the emergency care data set.
Turning to the concerns your report rases in relation to the pressures in hospital emergency departments. The Government accepts that urgent and emergency care services have been below the high standards that patients should expect in recent years. The NHS has been broken and it will take time to fix. However, we are determined to do so and have committed to returning urgent and emergency care waiting times to the safe operational waiting time standards set out in the NHS Constitution.
The Health Secretary ordered a full and independent investigation into NHS performance to provide a frank assessment of the issues and challenges it faces. The investigation’s findings, published on 12 September, will feed into the Government’s work on a 10-year plan to radically reform the NHS and build a health service that is fit for the future.
In the short-term, a range of action is being taken by the NHS this year to improve urgent and emergency care performance, including by maintaining capacity gains in acute hospital beds and ambulance hours on the road achieved in 2023-24, increasing the productivity of acute and non-acute services across bedded and non-bedded capacity, and directing patients to more appropriate services in the community where these can better meet their needs.
Thank you once again for bringing these concerns to my attention.
Thank you for your report of 24 July regarding the death of Regan Edwin James Smith. I am replying as Minister with responsibility for urgent and emergency care.
Firstly, I would like to offer my sincere condolences to Mr Smith’s family and loved ones. It is vital that where Regulation 28 reports raise matters of concern, these are looked at carefully so that NHS care can be improved. I am grateful for you bringing these matters to my attention.
Your report raises concerns with an ineffective handover of test results between the ambulance service and the A&E staff at Ipswich Hospital, part of East Suffolk and North Essex NHS Foundation Trust (ESNEFT), as well as emergency department pressures. In preparing this response, Departmental officials have made enquiries with NHS England (NHSE) and East of England Ambulance Service NHS Trust (EEAST).
Regarding the formal clinical handover of patients, there are a number of protocols that should be followed. This includes standards set out by the General Medical Council on how patient information should be shared, and the NHS standard contract which sets out targets on handover delays. The responsibility for the implementation and oversight of protocols across England is at a local level. I understand that ESNEFT submitted evidence during the inquest which set out actions being taken locally to improve processes which you have considered and were content with. EEAST advise that in the East of England, all hospital A&Es have information systems to provide records of patients arriving by ambulance and that they are ensuring that ambulance patient care records are available as part of the assessment of patients who arrive at A&E by ambulance.
The rapid exchange of clinical information verbally remains an integral part of communication. However, work is ongoing with NHSE to provide IT support that can deliver improved sharing of electronic information across systems. Linking the ambulance computer aided despatch system and electronic patient record collected by ambulance services with emergency departments data will provide better information about the patient journey.
Further, to support learning and system improvement, an ambulance data set is also currently being rolled out across England. This will be achieved by linking patient data collected by ambulance services with data collected by emergency departments through the emergency care data set.
Turning to the concerns your report rases in relation to the pressures in hospital emergency departments. The Government accepts that urgent and emergency care services have been below the high standards that patients should expect in recent years. The NHS has been broken and it will take time to fix. However, we are determined to do so and have committed to returning urgent and emergency care waiting times to the safe operational waiting time standards set out in the NHS Constitution.
The Health Secretary ordered a full and independent investigation into NHS performance to provide a frank assessment of the issues and challenges it faces. The investigation’s findings, published on 12 September, will feed into the Government’s work on a 10-year plan to radically reform the NHS and build a health service that is fit for the future.
In the short-term, a range of action is being taken by the NHS this year to improve urgent and emergency care performance, including by maintaining capacity gains in acute hospital beds and ambulance hours on the road achieved in 2023-24, increasing the productivity of acute and non-acute services across bedded and non-bedded capacity, and directing patients to more appropriate services in the community where these can better meet their needs.
Thank you once again for bringing these concerns to my attention.