NHS England has put out a call to the public and NHS staff for input into an ongoing review of urgent care and emergency services.

The review, first announced back in January, is designed to help build a national framework fit for providing a safe and more efficient system that offers access to urgent and emergency care at all times.

The move was spurred by a blackening picture of urgent and emergency care services, which are beginning to crumble under the pressures of rising demand and greater costs, and are consuming resources at a greater rate each year. 

“We know that A&E is the pinch point of the health and care system and that staff are working very hard to provide the care they know the public need," said Professor Keith Willett, National Director for Acute Episodes of Care for NHS England.

“To relieve the pressure and design a system that is sustainable and fit to meet future challenges, we need as many patients, doctors, nurses and NHS colleagues as possible to get involved.”

NHS England has this week published the evidence base from its review thus far, as well emerging principles from it, and is now seeking wider opinion on its findings.

The review has highlighted a stream of weak points across the current structure. 

For example, the evidence shows that overall fragmentation of the system is leaving many patients unable to access the most appropriate help, leading to duplication and over-use of the most expensive services, "at significant cost to the NHS", it said.

The wide range of urgent care services available and lack of standardisation of services and labelling is creating patient confusion over how to access the right healthcare quickly, which also leads to "duplication, delay, increased clinical risk and poor patient experience".

The evidence base also indicates that there is variation in access to primary care services across England, which is driving many patients towards urgent and emergency care services for conditions that could be treated in primary care, NHS England notes.

'Whole-system' approach crucial

The report concludes that there is "a clear need to adopt a whole-system approach to commissioning more accessible, integrated and consistent urgent and emergency care services to meet patients' unscheduled care needs".

But according to Sir Keogh, current concerns around A&E performance "should be seen as a stimulus and opportunity to improve the way we offer care between our hospitals, primary and community care and social services".

"Better integration and communication between these services could reduce unnecessary attendances at A&E and enable people in hospital to return home sooner," he said, noting that "this in turn could free up hospital beds so patients who need admission from A&E would not be kept waiting so long".

The public consultation on the evidence and emerging principles so far is now open until August 11.