The Government’s urgent and emergency care plan for 2025/26 has been unveiled, backed by over £370m in capital investment.
The plan aims to shift more patient care into ‘more appropriate care settings’ as part of the move from hospital to community.
As part of this, it will invest £370m to deliver around 40 new same day emergency care and urgent treatment centres and up to 15 mental health crisis assessment centres, as well as an expansion of connected care records for ambulance services.
The DHSC also pledged almost 500 new ambulances will also be rolled out by March 2026.
The plan told leaders to commit to developing and testing winter plans for 2025/26, which as a minimum should show how systems will:
- Improve vaccination rates,
- Increase the number of patients receiving care in primary, community and mental health settings,
- Meet the maximum 45-minute ambulance handover time standard,
- Improve flow through hospitals with a particular focus on patients waiting over 12 hours and making progress on eliminating corridor care,
- Set local performance targets by pathway to improve patient discharge times, and eliminate internal discharge delays of more than 48 hours in all settings.
Shift to community
On increasing the number of patients receiving treatment in community settings, it suggested ICBs should provide evidence of how NHS providers and local authorities will improve discharge and admission avoidance in their system.
It said: ‘Achieving this shift is everyone’s responsibility and requires everyone’s full participation. As part of their system winter plan submission, ICBs will need to evidence how NHS providers and local authorities (through health and wellbeing boards) will improve discharge and admissions avoidance.
‘System winter plans should build on the Better Care Fund (BCF) plans agreed between ICBs and local authorities in March 2025, which include local goals for performance on emergency admissions for over 65s and timely discharge.
‘Where ICBs and local authorities are facing challenges in achieving these goals, the newly formed Discharge and Admissions Group will agree improvement plans with them,’ it added.
It also stated that the neighbourhood health guidelines, published earlier this year, would help people stay independent for as long as possible and minimise the time people need to spend in hospital.
It said: ‘For patients living with frailty or complex needs, neighbourhood multidisciplinary teams have been shown to reduce demand on hospital-based unplanned care.
‘In Northamptonshire, local integrated teams involving a range of health and care providers are delivering responsive interventions, such as extended GP reviews, peer support groups, clinical-supported decision-making and remote monitoring. In the 18 months to March 2023, this approach resulted in a 9% reduction in hospital attendances for over 65s and a 20% reduction in falls-related acute attendance due to improved rapid response.’
It also called on the winter plans to set out how systems will expand access to urgent care services at home and the community.
‘This includes understanding the actual volume and optimising the use of urgent community response and virtual ward capacity in each integrated care system (ICS) as well as planning with the ambulance service and 111 how to use this capacity most effectively,’ it said.
Prevention
There was also a focus on prevention, including increasing uptake of vaccination. This was both for frontline staff and for children.
The plan called for the system to improve vaccination rates for frontline staff towards the pre-pandemic uptake level of 2018/19, or the equivalent of at least five percentage points.
It also said regions would be working with ICBs to develop a plan by the end of Q1 on how to strengthen their childhood vaccination offer, as part of reducing demand for urgent care later this year.
As a minimum, these plans will set out how GPs and school-aged vaccination providers will increase vaccination rates, and how local campaigns will target those in clinical risk groups. To support this, the plan said that health visitors would be used to administer childhood flu vaccinations and other routine immunisations for children.
Plans should also set out a delivery approach to year-round respiratory syncytial virus (RSV) vaccination for older adults and pregnant women, it added.
NHS England will also expand the use of the national booking service for flu vaccination this year to make more appointments available, including keeping the service open until March, following feedback last year. From October 2025, patients will also be able to look up where they can walk in to a community pharmacy and get a flu vaccination, through a ‘flu walk-in finder’.
Flow through the system
On improving flow through hospitals, the urgent care plan also called on ICBs to consider commissioning guidance so parents can navigate the health system more effectively. It gave the example of Healthier Together, the online platform to help parents navigate child health development, as a way to do this.
The plan called for ICBs alongside acute trusts and local authorities to eliminate the longest and ‘most unacceptable’ discharge delays, starting with those who wait more than 21 days beyond their discharge ready date.
It suggested that systems that are struggling to improve discharge could use additional guidance and best practice, such as those included in the neighbourhood health guidelines where neighbourhood multidisciplinary teams can help those with more complex needs to return home.
The plan added that digital investment, such as the adoption of the Federated Data Platform (FDP) and connected care records, would also boost flow through the system.
Health secretary Wes Streeting said: ‘The package of investment and reforms we are announcing today will help the NHS treat more patients in the community, so they don’t end up stuck on trolleys in A&E.
‘Hundreds of new ambulances will help cut the unacceptably long waiting times we’ve seen in recent years. And new centres for patients going through a mental health crisis will provide better care and keep them out of A&E departments, which are not well equipped to care for them.’
NHS chief executive, Sir Jim Mackey, added: ‘This major plan sets out how we will work together to resuscitate NHS urgent and emergency care, with a focus on getting patients out of corridors, keeping more ambulances on the road, and enable those ready to leave hospital to do so as soon as possible.’
In response to the plan, Matthew Taylor, chief executive of the NHS Confederation, said: ‘Health leaders across systems, providers and primary care will welcome this plan to provide better, faster and more appropriate emergency care, an area which is facing high demand and rising public concern over performance.
‘As the plan shows, there is a lot of good practice across the health service to build upon, including expanding the number of same day emergency treatment, mental health crisis assessment centres and rolling out more ambulances.
‘Making sure the NHS does not continue to fall into crisis each winter will be essential for improving public confidence in the health service,’ he added. ‘Strong collaboration between health partners and with local government to improve discharges out of hospitals will also be key to progress.’
Chief executive of NHS Providers, Daniel Elkeles said there was ‘a lot to like about this plan’.
‘It’s helpful that we’re seeing it in early summer, with time to ensure meaningful measures are in place ahead of the added pressures of winter,’ he said.
‘It’s also good to see that so many parts of the system, including primary, community and mental health care, in addition to ambulance and hospital services, have been factored in.’
He said the extra capital investment was ‘particularly welcome’, as well as the emphasis on vaccination.
‘This plan should result in meaningful progress compared to last winter,’ he said.
It comes ahead of the spending review, which is due on 11 June. Health experts have previously called for an investment in prevention and social care in the review, which has been labelled a ‘crucial moment’.
