Urgent and Emergency Care Survey: The 2022 Results and the Path to Recovery

Urgent care services play a crucial role in providing timely and life-saving medical attention to those in need. The 2022 Urgent and Emergency Care Survey, commissioned by Care Quality Commission and coordinated by Picker, sought to assess the state of urgent care services in England and to highlight what the biggest challenges currently are. Here we will look into the survey results, examining the issues in both Type 1 A&E departments and Type 3 Urgent Treatment Centres (UTCs). We will explore possible reasons behind the decline in results, discuss how the broader system affects urgent care services, and highlight how the NHS recovery plan will seek to improve patient experience.

The Current Issues in Urgent and Emergency Care Services

The 2022 survey results are disappointing and show a concerning downward trend across all key indicators in both Type 1 A&E departments and Type 3 Urgent Treatment Centres. Prolonged waiting times have become a significant concern, with 32% of A&E patients waiting for more than 60 minutes before speaking to a nurse or doctor – representing a 16%-point significant increase compared to 2020. This increased delay in access to care poses a risk to patients, with their condition likely deteriorating the longer the delay is.

Furthermore, a considerable number of A&E patients (56%) reported not receiving help with their condition or symptoms while waiting, a significant increase of 12%-points from the previous year. The percentage of A&E patients who had enough time to discuss their condition with medical staff also decreased from 74% to 66%, representing an 8%-point significant decrease (UTCs also saw a significant drop in this measure from 85% to 80%) .

Issues of communication and support are also evident. The availability of medical or nursing staff to provide assistance to those who needed attention, saw a 13% point significant decrease, while the provision of post-discharge care and support for A&E patients dropped by 11%-points compared to the previous year (and 5%-point drop for UTC patients).

Factors Influencing Decline in Results: Broader System Struggles

The decline in 2022 survey results can be attributed to several factors that have put strain on the entire system. The increasing demand for healthcare services, driven by a growing and ageing population, combined with staff shortages and limited capacity, has placed significant pressure on urgent care services. This means that urgent care services are struggling to uphold the Picker principle of “Fast access to reliable healthcare,”. Fast access to reliable care is of high importance in urgent care services, as patients seek immediate attention for their medical needs.

Additionally, challenges in accessing primary care services have led to increased reliance on urgent care services. Difficulty in securing timely appointments with General Practitioners has driven patients to seek immediate attention at A&E departments or Urgent Treatment Centres (UTCs). Notably, 17% of UTC patients stated that they visited the UTC because they could not get a quick GP appointment, which is a 5%-point significant increase.

Moreover, the decline in results may also reflect issues with NHS communications and patient awareness. Many patients may not fully understand the most appropriate channels to access healthcare services, leading to a higher influx of patients at A&E departments, even for non-urgent cases that could have been addressed through primary or community care. This is reflected in the survey results with almost four in ten (37%) patients going straight to A&E without contacting another service first, and over half (53%) of patients going straight to a UTC without contacting another service.

The Picker principle of “Continuity of care and smooth transitions” is of utmost importance, particularly to reduce reattendance and ensure the patient continues to receive the care they need by the right service. The significant decrease in A&E patients receiving sufficient information for post-discharge care (9%-point decrease) and the availability of expected care and support post-A&E discharge (11% decrease) highlight the need for improved coordination within the wider system to improve continuity of care and transitions for patients.

The Path to Recovery: Expanding Virtual Wards and Improvement Measures

Recognising the need to address these challenges, NHS England has developed a comprehensive recovery plan. This plan focuses on several key areas that aim to enhance urgent care services and patient experience.

One notable measure is the expansion of virtual wards, which use technology and remote monitoring to provide care and support for patients at home. By reducing the need for hospital admissions, it is hoped that virtual wards can help alleviate the burden on A&E departments, ensuring faster access to care for those with critical needs.

Improvement measures also include increasing capacity in urgent care settings, by recruiting additional staff and upgrading facilities, with an aim help address the issue of prolonged waiting times, and to improve the overall efficiency of urgent care services.

Conclusion

The results of the Urgent and Emergency Care Survey 2022 have highlighted the struggles within urgent care services in England. Longer waiting times, communication gaps, and limited resources have contributed to a decline in patient experience. Understanding the impact of the broader healthcare system on urgent care services is vital in ensuring positive change.

By focusing on the expansion of virtual wards, enhancing capacity, and improving communication and coordination, we hope that the NHS can recover and strengthen urgent care services. Implementing these measures could address the current challenges and also uphold the Picker principles of person-centred care, of ensuring that patients have fast access to reliable healthcare, and smooth transitions throughout the system.