Department of Health and Social Care
Central Government
Noted
The Department of Health and Social Care acknowledges the concerns and outlines actions being taken by NHS England and EEAST to improve ambulance response times, including increased recruitment, clinical triage of calls, and the establishment of an Unscheduled Care Coordination Hub. (AI summary)
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Dear Mr Parsley,
Thank you for your letter of 7 November 2023 to the Secretary of State for Health and Social Care regarding the death of Gina Bywater. I am replying as Minister with responsibility for urgent and emergency services. Please accept my sincere apologies for the delay in responding to this matter. I would like to assure you that the Department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how deeply sorry I was to read the circumstances of Ms Bywater’s death and I offer my sincere condolences to her family. 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 to you for bringing these matters to my attention.
In preparing this response, Departmental officials have made enquiries with NHS England (NHSE). NHSE advise that EEAST is implementing an operational performance and improvement plan locally to improve efficiency and maximise ambulance availability. This includes recruitment to increase the number of frontline clinicians, and also to increase the clinical triage of calls to identify patients that can be appropriately transferred to alternative services, including for Category 2 incidents where the severity of conditions can vary substantially. This helps to free up frontline resource to respond more quickly to those who need an ambulance response most urgently. This has also been supported by the establishment of an Unscheduled Care Coordination Hub.
As the Minister responsible for urgent and emergency care services, I recognise the significant pressure the urgent and emergency care system is facing and the impact of waiting times for patients. In January 2023, NHS England published a two year 'Delivery plan for recovering urgent and emergency care services’ which aims to deliver sustained improvements in waiting times, with a target for this year to reduce Category 2 ambulance response times to 30 minutes on average. An update to this plan has now been published, to build on learnings from the first year and to continue to support systems to improve performance and reduce waiting times. The plan is available at:
recovering-urgent-and-emergency-care-progress-update-and-next-steps-May-2024.pdf
Your report highlights that EEAST and local hospitals were experiencing high demand and long handover delays. To support ambulance services, ambulance trusts received £200 million of additional funding in 2023/24 to expand capacity and improve response times. In addition, to improve patient flow and bed capacity within hospitals £1 billion of dedicated funding was provided to increase staffed core hospital beds by 5,000 compared to 2022/23 plans.
£1 billion was invested this year through the Discharge Fund in commissioning packages of care for people being discharged and improving discharge processes. A £40 million fund was also launched in September 2023 for local authorities in areas with the greatest challenges on urgent and emergency care. Local authorities used this funding for social care provision and strengthening admissions avoidance and discharge services over the past winter. The number of people discharged from hospital with packages of health and social care support has increased by 9% from the end of March 2023 to the end of March 2024.
NHS England also implemented a new tiering performance and improvement approach to support challenged ambulance trusts and wider systems. There is support in place at national and regional level to support Tiers 1 and 2 with EEAST in Tier 2 with a universal improvement support offer being made available for all systems.
Since publication of the recovery plan in January 2023, there have been improvements in performance. Nationally in 2023/24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13 minutes faster compared to the previous year, a reduction of over 27%. In the East of England, average Category 2 response times were over 23 minutes faster over the same time period, a 34% reduction. There have also been improvements in handover delays with average EEAST handover times 30 minutes 57 seconds in May 2024, almost 14 minutes faster than October
2023.
Thank you once again for bringing these concerns to my attention.
Yours,
HELEN WHATELY
Thank you for your letter of 7 November 2023 to the Secretary of State for Health and Social Care regarding the death of Gina Bywater. I am replying as Minister with responsibility for urgent and emergency services. Please accept my sincere apologies for the delay in responding to this matter. I would like to assure you that the Department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how deeply sorry I was to read the circumstances of Ms Bywater’s death and I offer my sincere condolences to her family. 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 to you for bringing these matters to my attention.
In preparing this response, Departmental officials have made enquiries with NHS England (NHSE). NHSE advise that EEAST is implementing an operational performance and improvement plan locally to improve efficiency and maximise ambulance availability. This includes recruitment to increase the number of frontline clinicians, and also to increase the clinical triage of calls to identify patients that can be appropriately transferred to alternative services, including for Category 2 incidents where the severity of conditions can vary substantially. This helps to free up frontline resource to respond more quickly to those who need an ambulance response most urgently. This has also been supported by the establishment of an Unscheduled Care Coordination Hub.
As the Minister responsible for urgent and emergency care services, I recognise the significant pressure the urgent and emergency care system is facing and the impact of waiting times for patients. In January 2023, NHS England published a two year 'Delivery plan for recovering urgent and emergency care services’ which aims to deliver sustained improvements in waiting times, with a target for this year to reduce Category 2 ambulance response times to 30 minutes on average. An update to this plan has now been published, to build on learnings from the first year and to continue to support systems to improve performance and reduce waiting times. The plan is available at:
recovering-urgent-and-emergency-care-progress-update-and-next-steps-May-2024.pdf
Your report highlights that EEAST and local hospitals were experiencing high demand and long handover delays. To support ambulance services, ambulance trusts received £200 million of additional funding in 2023/24 to expand capacity and improve response times. In addition, to improve patient flow and bed capacity within hospitals £1 billion of dedicated funding was provided to increase staffed core hospital beds by 5,000 compared to 2022/23 plans.
£1 billion was invested this year through the Discharge Fund in commissioning packages of care for people being discharged and improving discharge processes. A £40 million fund was also launched in September 2023 for local authorities in areas with the greatest challenges on urgent and emergency care. Local authorities used this funding for social care provision and strengthening admissions avoidance and discharge services over the past winter. The number of people discharged from hospital with packages of health and social care support has increased by 9% from the end of March 2023 to the end of March 2024.
NHS England also implemented a new tiering performance and improvement approach to support challenged ambulance trusts and wider systems. There is support in place at national and regional level to support Tiers 1 and 2 with EEAST in Tier 2 with a universal improvement support offer being made available for all systems.
Since publication of the recovery plan in January 2023, there have been improvements in performance. Nationally in 2023/24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13 minutes faster compared to the previous year, a reduction of over 27%. In the East of England, average Category 2 response times were over 23 minutes faster over the same time period, a 34% reduction. There have also been improvements in handover delays with average EEAST handover times 30 minutes 57 seconds in May 2024, almost 14 minutes faster than October
2023.
Thank you once again for bringing these concerns to my attention.
Yours,
HELEN WHATELY