NHS to test new rapid care measures for patients with the most urgent mental and physical health needs

People who arrive at A&E experiencing a mental health crisis will receive emergency care within one hour under NHS pilot schemes aimed at improving care and saving more lives.

The new standard, a significant step towards parity of esteem for mental health, is among a raft of proposed clinical improvements that aim to deliver rapid assessment and treatment for patients with the most serious conditions, and expand short waits for millions more NHS patients.

Patients experiencing a mental health crisis will also be able to access quick care in their own home or community, while no one who urgently needs help should wait more than 24 hours.

People with suspected cancer will receive a definitive diagnosis within 28 days of urgent referral by their GP or a screening service as part of the proposals, which will be field tested by the NHS.

Other new standards to be trialled include a rapid assessment measure for all patients arriving at A&E, coupled with faster life-saving treatment for those with the most critical conditions, such as heart attacks, sepsis, stroke and severe asthma attacks.

The proposals will support staff to focus on what matters most to the public and saves lives, including early assessment of everyone coming to A&E, the rapid start of treatment for those with the most serious illnesses and injuries.

A new measure of time in emergency department will also be tested, with the aim of ending hidden long waits and providing a more accurate view of hospital performance by recording how long every patient spends in A&E, not just whether their discharge or admission time breached the target.

This could prevent tens of thousands of unnecessary hospital admissions each year by improving upon the current four hour ‘cliff edge’ target.

Around a fifth of all emergency admissions from A&E happen in the final 10 minutes before the deadline, suggesting that hospitals are being driven to focus on the target, rather than what is the best approach for each patient.

In addition, the proposals will strengthen rules on reporting prolonged waits for those who need to be admitted to a ward, including reporting the most serious cases to the Care Quality Commission watchdog as a patient safety concern.

The use of average waiting times is based on the success of new ambulance standards, which have seen average waiting times for the most urgent calls improve by 14% over the last year, despite an increasing number of call-outs.

Professor Ted Baker, chief inspector of hospitals for the Care Quality Commission, said: “The four hour A&E standard has been valuable in focussing efforts on improving emergency care but if we are to continue to improve patient safety and ensure every patient gets the priority they individually need it must be reformed and we must find better measures to ensure patient safety.

“Emergency departments need a set of standards which gives priority to patients with life-threatening conditions, ensures people get care in a timely way and puts pressure on the whole hospital to end long corridor waits for those who need admitting. We are confident that field testing these proposals is the safest and most effective way of improving care.”

Professor Carrie MacEwan, president of the Academy of Medical Royal Colleges said: “We support any moves that improve the quality of care. If, as seems likely, the new standards on cancer, mental health, waiting times for both elective (referral to treatment times RTT) and in emergency care are demonstrably in the best interests of patients then we will support those. We look forward to working with NHS England and other stakeholders on a full evaluation of the pilot studies and any subsequent changes that are decided upon as a result.”