Concern over emergency care

In the most comprehensive review of NHS emergency and urgent care services, the report found wide variations in how patients across England are treated.

People are confused over where to seek help, face unnecessary delays on being admitted to hospital, and some out-of-hours care is poor, it said.

More than one in three out-of-hours services cannot demonstrate that they meet national requirements on assessing patients within a set time-frame.

The commission also found that the proportion of calls prioritised as "urgent" in out-of-hours care varied from under 4 per cent to more than 32 per cent between services, "raising questions" over consistency.

There were also fears over how quickly patients taken to A&E in an ambulance start receiving care.

In some A&E departments, for 95 per cent of the time, ambulances are back on the road within 15 minutes of delivering a patient, but in other departments this figure is as low as 10 per cent.

Anna Walker, chief executive of the Healthcare Commission, said: "How an area deals with emergency and urgent care is absolutely a cornerstone of 21st century care.

"There remains issues for patients about access to these services. Where we have found weaker performance, it tends to be out-of-hours services not working as well, more difficult access to GPs... and services that are less good for vulnerable groups, such as those with disabilities and long-term conditions."

She said people were "confused about the services out there" and where services were located.

And she said the commission was calling for a network target looking at how quickly a patient receives care from the moment they call an ambulance to being admitted to A&E.

Professor Sir George Alberti, the government's national director for emergency access, said: "Urgent and emergency care offered across most of the NHS to millions of people each year is of a high standard and we welcome the results of this review by the Healthcare Commission.

"We are not complacent and we recognise the importance of encouraging continuous improvement in local services to ensure the delivery of timely, high quality care to patients.

"That is why we are working with the Healthcare Commission to host three national events to help primary care trusts use this review to take stock of where they are and develop their commissioning plans to deliver the expectations set out in the next stage review to improve urgent and emergency cares services to patients."

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