Listening to health and care leaders: supporting Integrated Care Systems to deliver safe and effective urgent and emergency care

Published: 20 September 2022 Page last updated: 21 September 2022

NHS and social care services are under extreme pressure. There have been record delays for people waiting for ambulances and treatment in hospital.  

Difficulties in accessing care in the community has led to avoidable hospital admissions. And, a lack of available social care support has meant unnecessarily long stays in hospital for people ready to leave - reducing the number of beds and staff available for other patients.  

To provide ongoing support to services managing the current challenges, we have continued our work with CQC’s National Emergency Medicine Specialist Advisor Forum. The forum consists of senior medical professionals who provide specialist advice to CQC. They see the impact of the current pressures on people and staff every day.  

In May, the forum helped CQC to host an urgent and emergency care workshop. The event involved 250 representatives from adult social care, primary care, community healthcare, urgent care, and NHS hospital and ambulance trusts.

Their discussions focussed on the challenges that services and staff are facing. And attendees shared their views on what action is needed from: 

  • Integrated Care System (ICS) leaders 
  • Staff on the frontline 
  • National oversight bodies, including CQC 
  • Government. 

CQC’s National Emergency Medicine Specialist Advisor Forum has used the ideas put forward at the workshop to develop PEOPLE FIRST.  

PEOPLE FIRST is an online resource for system leaders and service providers. It presents suggested actions for individual services and the wider system to help: 

  • make the best use of resources 
  • build capacity 
  • ensure safety remains a priority.

Dr Sean O’Kelly, CQC’s Chief Inspector of Hospitals, said “Nowhere is the interdependent nature of the relationship between health and social care more obvious – and more critical - than in urgent and emergency care. PEOPLE FIRST builds on our existing Patient FIRST resource by recognising the crucial importance of that relationship to ensuring that people get good care when they need it.

“Created by senior emergency care clinicians from CQC’s National Emergency Medicine Specialist Advisor Forum, it provides practical ideas and guidance to help Integrated Care Systems and the services within those systems, to deliver a truly person centred urgent and emergency care pathway.  

“The ideas presented within the tool support efforts to ensure collaborative system leadership, where safety risks are shared and owned by all sector partners. They include suggested actions to increase flow, improve staff retention, and encourage a culture of learning and improvement.  

“CQC has repeatedly highlighted the challenges we see facing urgent and emergency care services and the importance of system wide service collaboration in their delivery. While there are no quick fixes, we are committed to supporting moves towards a new model for urgent and emergency care and to help share good practice and drive innovation across the system.”