Urgent care pathways
Deficiencies in urgent care pathways for serious but non-immediately life-threatening conditions, leading to delays and poor outcomes.
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
GIRFT recommendation
100match
Children and Young People's Mental Health Services
The crisis and urgent care pathways, including inpatient admissions, must be seamless with consistent treatment plans, objectives, and care coordination. In most circumstances, this will require the community care coordinator remaining as the main point of contact and driver of care regardless of the crisis, urgent care or inpatient setting the patient is within. There must be a...
Matched on
exact phrase
terms: care, pathway, urgent
Committee recommendation
86match
#3 - Clearly set out causes of urgent care performance variation and initiatives to improve standards.
The quality of patients’ access to urgent and emergency care depends too much on where they live, particularly with wide variation in ambulance response times. There is significant regional variation in the performance of services for urgent and emergency care. For example, in 2021–22, average ambulance response times for the most serious incidents varied from six minutes 51...
Matched on
terms: care, urgent
GIRFT recommendation
83match
Endocrinology
Consider options to accelerate urgent treatment for patients with serious non-cancer endocrine conditions. a GIRFT to work closely with NHS England and trusts to review referral pathways for life-threatening endocrine conditions or conditions which have risks of major complications (listed below) to ensure that patients can access urgent treatment without unnecessary delay once diagnosis is confirmed: i. phaeochromocytoma;...
Matched on
terms: pathway, urgent
CQC enforcement action
82match
Urgent Enforcement Action: North Cumbria Integrated Care NHS Foundation Trust
Following an unannounced inspection of the Emergency Department at the Cumberland Infirmary in February 2026, inspectors found areas of good practice as well as a number of concerns. CQC issued formal notification of a Section 31, which grants the CQC the ability to impose conditions on a provider’s registration. The main areas of concern were around the care...
Matched on
terms: care, urgent
GIRFT recommendation
81match
Vascular Surgery
Increase the early availability of revascularisation surgery where lower limb ischaemia is present, to reduce amputation rates. 5A: GIRFT and NHSE to discuss faster referral to treatment times for revascularisation, as well as more rapid referral from primary care, and ensure evidence base for any proposed change. 5B: Clinicians and trust management to progress as far as possible...
Matched on
terms: care, pathway, urgent
GIRFT recommendation
81match
Cranial Neurosurgery
Reduce the proportion of primary malignant brain cancer patients that are admitted via the emergency/non-elective stream. 6A: Unless contraindicated, trusts to provide an urgent care pathway for malignant brain cancer, consisting of elective admission, preferably on the day of surgery, within a week of referral. 6B: GIRFT to produce guidance on how to replicate the University Hospital Southampton...
Matched on
terms: care, pathway, urgent
CQC enforcement action
81match
Conditions Imposed: Mid and South Essex NHS Foundation Trust
The Care Quality Commission (CQC) placed conditions on Basildon University Hospital's registration, requiring leaders to act immediately on urgent safety concerns and provide regular updates on improvements. This action followed inspections between December 2024 and March 2025, which found serious overcrowding in the emergency department, risking people's safety. Inspectors observed people waiting over 12 hours, staff not always...
Matched on
terms: care, urgent
PPO recommendation
81match
The Head of Healthcare
The Head of Healthcare should ensure that there is: • Adequate training for nurses responsible for assessing the clinical condition and appropriate treatment pathways for prisoners, and • At least one nurse trained in advanced clinical assessment skills during all day shifts within one year and that nurses should be trained to this level before answering Urgent Assessment...
Matched on
terms: care, pathway, urgent
Committee recommendation
74match
#1 - Evidence taken from DHSC and NHS England on access to unplanned or urgent care.
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department) and NHS England about access to unplanned or urgent care.1
Matched on
terms: care, urgent
PFD report
73match
Dorothy Townley
Insufficient direct communication between District Nurses and the GP, especially regarding patient condition, wound care, and urgent blood tests. The District Nursing Team also lacked knowledge and training in burns treatment, and their wound assessment chart was inadequate.
Matched on
terms: care, urgent
PFD report
73match
Barnabas Newlyn
The coroner noted that road transfer times for critically ill patients, especially neurosurgical emergencies, between distant hospitals and specialist facilities may not allow sufficient time for life-saving interventions. Healthcare staff needing urgent transfers were advised to consider air transfer first.
Matched on
terms: care, urgent
PFD report
73match
Leslie Summerfield
The coroner raised concerns about the withdrawal of urgent endoscopy services at Trafford General Hospital, questioning the safety of treating acutely unwell patients requiring such essential procedures at the facility. This led to patient transfers and delays in accessing critical care.
Matched on
terms: care, urgent
CQC enforcement action
73match
Conditions Imposed: Liverpool University Hospitals NHS Foundation Trust
The Care Quality Commission (CQC) imposed conditions on Liverpool University Hospitals NHS Foundation Trust's registration under Section 31 of the Health and Social Care Act 2008. This action was taken due to significant concerns identified during an inspection, including issues with patient access and flow in the emergency department and lengthy delays. The conditions require the trust to...
Matched on
terms: care, urgent
PFD report
69match
Jacqueline Allwood
The coroner identified concerns regarding the absence of an agreed protocol for managing calf pain and suspected DVT at the Urgent Care Centre. Additionally, questions were raised about a specific GP's understanding and acceptance of normative diagnostic standards and the adequacy of practice changes.
Matched on
terms: care, urgent
GIRFT recommendation
69match
Urology
Review the approach to providing care for patients who require urgent surgery for urinary tract trauma and related conditions. 13A: Trusts to consider options for improvement locally. 13B: BAUS and GIRFT to develop guidance for local adoption. 13C: Trusts to implement guidance as appropriate. 13D: GIRFT to discuss workforce issues with HEE.
Matched on
terms: care, urgent
GIRFT recommendation
69match
Stroke
Improve access to and time to thrombectomy intervention. Aiming for 8% of all patients with stroke accessing thrombectomy by 2025. a) Develop the Thrombectomy Implementation Group (TIG) further to coordinate the national response, working closely with stakeholders. b) Develop clear plans with implementation milestones and use data to monitor process and outcomes. c) Implement hub and spoke pathways...
Matched on
terms: care, pathway
CQC action
69match
Westmorland General Hospital
The trust should consider completing the urgent and emergency care plans that have been delayed so that these can feed into the medicine care group strategy.
Matched on
terms: care, urgent
CQC enforcement action
69match
Conditions Imposed: University Hospitals Birmingham NHS Foundation Trust
The Care Quality Commission placed conditions on University Hospitals Birmingham NHS Foundation Trust's registration. This action followed inspections where the trust had not met the requirements of a previous warning notice and further issues were identified. Conditions were also imposed due to concerns regarding safeguarding practices within three urgent and emergency care services.
Matched on
terms: care, urgent
CQC enforcement action
69match
Warning Notice: Barts Health NHS Trust
The Care Quality Commission (CQC) issued a warning notice to Barts Health NHS Trust following an inspection of Whipps Cross University Hospital's urgent and emergency services in July. CQC found people experienced very long waits in the emergency department, leading to risks to their safety, privacy, and dignity, and were not always triaged in a safe and timely...
Matched on
terms: care, urgent
CQC enforcement action
69match
Conditions Imposed: Portsmouth Hospitals NHS Trust
The Care Quality Commission (CQC) placed four conditions on Portsmouth Hospitals NHS Trust's registration following an inspection of its urgent and emergency department. Inspectors found the emergency department at the Queen Alexandra Hospital was over-crowded with patients not being assessed or treated in a timely way. The trust was rated Inadequate for Urgent and Emergency services.
Matched on
terms: care, urgent
CQC enforcement action
69match
Warning Notice: Brighton and Sussex University Hospitals NHS Trust
The Care Quality Commission told Brighton and Sussex University Hospitals NHS Trust that it must make significant improvements to its Urgent and Emergency Services, specifically concerning the Emergency Department at Royal Sussex County Hospital. Following an inspection on 22 June, CQC raised concerns about patient flow and the timeliness of care, rating two aspects of urgent and emergency...
Matched on
terms: care, urgent
Committee recommendation
69match
#4 - Ensure all FGM survivors access timely, essential support and specialist care nationwide
The Government should ensure that all FGM survivors can access the essential support and care they need in a timely manner. While some variation in service provision may be necessary to reflect local prevalence rates, higher-prevalence areas should offer funded multidisciplinary services that allow quick access to specialist care. In lower-prevalence areas, there must be clear referral pathways...
Matched on
terms: care, pathway
CQC enforcement action
68match
Conditions Imposed: The Princess Alexandra Hospital NHS Trust
The Care Quality Commission (CQC) placed conditions on The Princess Alexandra Hospital NHS Trust's registration following an inspection in July, August and September. This action was taken due to serious concerns found regarding the lack of monitoring of patients waiting to be seen in the emergency department. The conditions require the trust to introduce a process for prioritising...
Matched on
terms: care, urgent
PFD report
65match
George Boulton
The coroner identified insufficient escalation protocols for suspected stroke patients across primary care, bed bureau, and ambulance services, leading to delays in emergency response and risking timely diagnosis and treatment options.
Matched on
terms: care
GIRFT recommendation
65match
Paediatric General Surgery and Urology
Improve the care of children requiring emergency paediatric surgery for appendicitis and testicular torsion. a NHS England and NHS Improvement, Royal College of Surgeons (RCS), Royal College of Paediatrics and Child Health (RCPCH), Royal College of Anaesthetists (RCA) and Royal College of Radiologists (RCR) to produce a model appendicectomy pathway which includes: • ED to diagnosis (ultrasound, assessment...
Matched on
terms: care, pathway
GIRFT recommendation
65match
Ophthalmology
Develop a clear pathway for out-of-hours emergency eye care, implemented locally and regionally and agreed among all providers, supported by contractual arrangements and SLAs. Actions: a) Commissioners and providers to agree pathways to deliver this, drawing on best practice outlined in RCOphth OSG, SAFE and other CCEHC frameworks. b) Commissioners and providers to ensure that agreed pathways are...
Matched on
terms: care, pathway
GIRFT recommendation
65match
Neurology
Ensure that all patients with acute neurological disorders can promptly access neurology services, including through acute neurology clinics. Actions: a) Ensure neurology services are available at all sites admitting patients with acute neurological disorders, either on site or through defined links with another site. If services are not available, appropriate pre-hospital triage should divert patients to sites with...
Matched on
terms: pathway, urgent
GIRFT recommendation
65match
Emergency Medicine
Trusts to ensure timely access to urgent care services and specialist opinions such that patients only attend ED when it adds value to their care.
Matched on
terms: care, urgent
CQC action
65match
University Hospital Aintree
The trust must ensure that work continues to improve performance against national urgent and emergency care standards; including time to triage, time to clinical review, and time in the department.
Matched on
terms: care, urgent
CQC action
65match
Kidderminster Hospital and Treatment Centre
The needs of patients with minor injuries are included in the new strategy for the urgent care division.
Matched on
terms: care, urgent
CQC action
65match
Kettering General Hospital
The service should continue to explore how it improves speciality response times in the urgent and emergency care department.
Matched on
terms: care, urgent
CQC enforcement action
65match
Warning Notice: University Hospitals Plymouth NHS Trust
The Care Quality Commission (CQC) issued University Hospitals Plymouth NHS Trust with a warning notice following an inspection of Derriford Hospital's urgent and emergency care department in March. CQC found that the trust must make significant and immediate improvements, outlining areas for improvement including two breaches of legal requirements. Inspectors found a deterioration in the quality of services,...
Matched on
terms: care, urgent
CQC enforcement action
65match
Conditions Imposed: Portsmouth Hospitals NHS Foundation Trust
The Care Quality Commission (CQC) placed four conditions on the registration of Portsmouth Hospitals NHS Trust following an inspection of emergency services at Queen Alexandra Hospital. CQC found that too many people were waiting too long for attention in the Emergency Department, leading to overcrowding and delayed treatment. The conditions require the trust to make immediate improvements to...
Matched on
terms: care
HSSIB recommendation
65match
Provision of mental health care to patients presenting at the emergency department
It is recommended that NHS England ensures there is a sustainable funding model to support 24/7 urgent and emergency mental health liaison services in acute general hospitals with emergency departments.
Matched on
terms: care, urgent
CQC enforcement action
64match
Conditions Imposed: Shrewsbury and Telford Hospital NHS Trust
The Care Quality Commission imposed urgent conditions on Shrewsbury and Telford Hospital NHS Trust's registration following inspections of its maternity and emergency departments. Inspections highlighted concerns regarding reduced foetal movements guidelines in maternity services and the treatment and recognition of sepsis in urgent and emergency care. The conditions require the trust to report weekly to CQC on actions...
Matched on
terms: care, urgent
CQC enforcement action
64match
Conditions Imposed: Croydon Health Services NHS Trust
The Care Quality Commission (CQC) told Croydon Health Services NHS Trust that it must improve the quality of care provided to patients in mental health crisis in its urgent and emergency services at Croydon University Hospital. Following an unannounced, focused inspection in October, CQC took enforcement action and imposed conditions against the trust registration. These conditions require the...
Matched on
terms: care, urgent
IOPC learning recommendation
64match
Investigation into police contact with a man following a report into his behaviour and welfare - Merseyside Police,...
The IOPC recommends that Merseyside Police ensures that there is a robust agreement in place between the force and North West Ambulance Service NHS Trust in relation to people who come into contact with the police and require urgent medical attention’, including people showing signs of Acute Behavioural Disturbance (ABD). This agreement must ensure that the ambulance service...
Matched on
terms: care, urgent
NCEPOD recommendation
62match
In Hospital Care of Out-of-Hospital Cardiac Arrests
Matched on
terms: care
PFD report
61match
Chloe Grace Flavell
The coroner noted concerns regarding the management of the reception area before triage, which could lead to significant delays in providing immediate care, particularly for children. A more appropriate and efficient system is needed to minimise these delays.
Matched on
terms: care
PFD report
61match
Stephen Bedford
Concerns were raised regarding the regular assessment of emergency care staff for life support standards, and if paramedics with advanced life support training should be mandated for all Code Red and PPCI transfers. Further issues included training for ECG machines for certain staff, and specific guidance for communicating with relatives.
Matched on
terms: care
PFD report
61match
Sandra Bodrozic
Concerns were raised about delays in securing an informal hospital admission for the patient and a lack of exploration of private bed options. Further concerns noted delays in arranging Mental Health Act assessments, with no clear protocols for timeframe or communication regarding urgent assessment options.
Matched on
terms: urgent
PFD report
61match
David Mostari
The coroner noted an inadequate system for ensuring urgent diagnostic tests, such as x-rays and ultrasounds, are performed without delay, particularly for patients admitted at weekends.
Matched on
terms: urgent
PFD report
61match
Sandra Wood
The NHS Trust does not have facilities for routine CT scans on weekends, and the urgent scan procedure can cause delays, as a required scan was postponed until after the weekend.
Matched on
terms: urgent
PFD report
61match
June Parkes
Deficiencies in provision and protocols for urgent and emergency endoscopies and surgery were identified. Concerns also included staff compliance with the NEWS system, record-keeping, and criteria for doctor presence during critical patient transfers.
Matched on
terms: urgent
PFD report
61match
Teresa Dennett
The coroner identified concerns regarding the absence of a clear pathway for referral for life-saving neurosurgery, alongside issues with diagnostic imaging and the input from stroke physicians in appropriate cases.
Matched on
terms: pathway
HSSIB recommendation
61match
HSIB’s local investigation pilot: shared learning for local healthcare systems
HSIB national investigation ‘Harm caused by delays in transferring patients to the right place of care .’
Matched on
terms: care
CQC enforcement action
60match
Warning Notice: Gloucestershire Hospitals NHS Foundation Trust
The Care Quality Commission (CQC) issued a warning notice to Gloucestershire Hospitals NHS Foundation Trust following an unannounced inspection of urgent and emergency services at Gloucestershire Royal Hospital in December. The inspection was prompted by concerns from people using the service, staff, and visitors regarding cleanliness and fire safety. CQC found poor environmental safety standards with blocked fire...
Matched on
terms: care, urgent
PFD report
57match
Thomas Smith
The coroner identified gaps in complete and accurate handover information between primary and secondary care, raising concerns about the prioritisation of children's cases in out-of-hours services. The report also noted a need to revisit national guidance on pre-hospital antibiotics for suspected meningitis and highlighted a fragmented approach to patient care in hospitals where nursing staff concerns were not...
Matched on
terms: care
PFD report
57match
Patricia Chapman
The revised training and flowchart for community hospital staff does not include a mechanism for obtaining emergency medical advice from experts in acute hospitals, which could be beneficial in urgent situations.
Matched on
terms: urgent
PFD report
57match
Robert Hogg
The coroner noted concerns that NHS Pathways for toddlers and children may not effectively identify very sick children, and that no changes have been made to address this ongoing risk.
Matched on
terms: pathway