The Health Overview and Scrutiny Committee met on Wednesday 17 June 2026 to discuss Urgent and Emergency Care (UEC) and Patient Flow. The committee received an update on the winter planning and performance for 2025-26, highlighting improvements in key metrics such as ambulance handover delays and Emergency Access Standard (EAS) performance. Discussions also covered hospital flow, community services, and the emerging Neighbourhood Health Framework.

Urgent and Emergency Care and Patient Flow

The committee received a comprehensive update on the state of Urgent and Emergency Care (UEC) and patient flow across Worcestershire. Representatives from NHS Herefordshire and Worcestershire Integrated Care Board (HWICB), Worcestershire Acute Hospitals NHS Trust (WAHT), Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT), West Midlands Ambulance Service University NHS Foundation Trust (WMAS), and Worcestershire County Council presented on the challenges and improvements experienced during the Winter 2025/26 period.

Despite a challenging operational period, the system has seen improvements in key UEC performance metrics, with these enhancements becoming more sustainable. The Winter Plan for 2025/26 focused on reducing ambulance handover delays, improving Emergency Department (ED) waiting times and Emergency Access Standard (EAS) performance, and reducing instances of corridor care. The plan also aimed to improve the response to frail and end-of-life patients and optimise acute and community bed capacity.

NHS England (Midlands) provided positive feedback on the progress made across the Herefordshire & Worcestershire Integrated Care System (ICS), noting stronger governance, visible leadership, and a more coordinated system-wide approach. Specific areas of commendation included ambulance handover performance, vaccination planning, and developments in primary and community care.

Emergency Department Activity and Performance: During winter 2025/26, overall front-door ED demand increased by 5% compared to the previous year, representing a 2% reduction in growth compared to the increase observed between Winter 2024 and Winter 2023. January 2026 was particularly challenging, while other months remained broadly comparable to the previous year. Ambulance activity also increased by 5%, largely due to the cessation of intelligent conveyancing.

To mitigate increasing demand, the Worcestershire System invested in the Single Point of Access (SPoA), which has successfully redirected over 250 patients per month away from the ED to primary care. The Same Day Emergency Care (SDEC) pathway also saw a 5% increase in patient throughput, helping to prevent unnecessary admissions.

Nationally, the ambition was to improve EAS performance to 78% by March 2026. The report highlighted that EAS performance at Worcestershire Acute Hospitals NHS Trust (WAHT) is at its highest levels in over four years and has moved from being the most challenged in the Midlands region to the 4th best.

Ambulance Handover Delays: Significant focus has been placed on reducing ambulance handover delays. Schemes such as the SPoA, Pit Stop, and Urgent Community Response have been implemented. The Worcestershire System committed to improving handover times, with a target of increasing the number of ambulances handed over within 45 minutes of arrival. These efforts have resulted in a 20% reduction in paramedic lost hours and a 12% reduction in ambulance handover delays over the winter period.

Hospital Flow: Work to improve hospital flow is ongoing through the urgent and emergency care reset programme, which includes workstreams focused on attendance/admission prevention, reducing length of stay, and early discharge. Initiatives such as the development of Acute Medical Assessment units and Acute Surgical Assessment areas have contributed to reduced lengths of stay and improved ED efficiency. The Hospital at Home service has also expanded, allowing patients to receive hospital-level care in their own homes.

Community Services: Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT) has played a key role in supporting patients at home, preventing avoidable hospital admissions, and facilitating earlier discharge. An improvement plan for Community Hospitals resulted in a reduction in average length of stay from 29 days to 24 days. Investment in Pathway 1 services significantly reduced waits for double-handed care, freeing up bed days and enabling more patients to move into community settings. The Hospital at Home service expanded its capacity, supporting around 80 people per month. The Community SPoA received over 1,000 referrals per month, and the Urgent Community Response (UCR) service achieved a 90% two-hour response rate against a 70% target.

Neighbourhood Health: The government's Neighbourhood Health Framework, published in February 2026, aims to place the person at the centre of local service organisation and delivery. In Worcestershire, a local Neighbourhood Health Delivery Framework is in place, supported by various providers. This, along with the Frailty Strategy, is beginning to show progress in reducing avoidable attendances, particularly among medical patients aged 75+ attending the ED.

The committee was informed that performance across key UEC metrics has improved and been sustained for a longer period than in the last four years. While further improvements are needed, the Worcestershire system is working collectively to enhance performance and patient experience.

Work Programme

The committee reviewed its work programme for 2026. It was agreed that Falls strategy and prevention and Medical obesity would be added to the work programme. There was also a discussion about inviting representatives from South Warwickshire to discuss their patient flow management, with the aim of learning from their approach. The committee also noted the need for clearer language in reports and a better understanding of the differences in demographics and services between Worcestershire and other comparable areas.

The committee acknowledged the importance of collaboration and a whole system approach to address the challenges within the NHS, drawing analogies to the efficiency of airlines and Formula 1 pit stops. The need to build intelligence and understand the root causes of issues was emphasised.

The next meeting of the Health Overview and Scrutiny Committee is scheduled for 21 July 2026.