9 February 2026
A publication which outlines key components of an Emergency Department will have some utility but is unlikely to have ‘meaningful impact’ on reducing overcrowding and the associated corridor care in departments.
That’s the assessment from the Royal College of Emergency Medicine following the publication of NHS England’s Model ED document today (9 February).
It contains a blueprint for Emergency Departments and associated facilities, including Urgent Treatment Centres, Same Day Emergency Care units, and the newly named Extended Emergency Medicine Ambulatory Care (EEMAC) facilities.
And it provides some detail about expected processes when a patient arrives at the Emergency Department along with an explanation of where patients may end up, and at which point in their journey
Dr Ian Higginson, President of the Royal College of Emergency Medicine said: “There is a lot to unpack in this publication from NHS England, which will have utility in helping organisations adopt a more standardised approach to the provision of emergency care facilities in England. This is a reasonable objective.
“At the same time, there is acceptance within the document that there may be a need for local variation at times, provided there are good reasons and that the quality of care is maintained.
“There is also a welcome acknowledgement around the problem of overcrowding, and that there is a need to adopt a “whole system” approach.
“However, in isolation this document is unlikely to have meaningful impact on reducing overcrowding given that it relates to only one piece of the jigsaw. Other pieces are missing and we look forward to seeing how the whole scene develops. The publication of the NHSE document relating to the first 72 hours is one example of how this picture needs to build up, and is welcome.
“Overcrowding and corridor care is ultimately driven by our inability to find beds for patients who need to be in hospital. This is because hospitals are full. Although it seems logical to start at the front door of hospitals, this is not really where the problem lies – we should be more concerned with how things are expected to look at the back door.
“In fact, Emergency Departments and our patients are stuck in the middle, because a lot also happens, and can happen, before patients even get to us.
“The back door of our hospitals needs the same level of attention that the front door is currently receiving. Only then, will we start to see patient flow restored in our hospitals. There is a risk this document propagates the same approach to managing the UEC pathway that has failed our patients for a number of years now.
“This document will provoke useful discussion about the way we do things, and does help add some clarity around some key issues. We are pleased to see the commitment to extended opening hours for urgent treatment centres that are sited next to Emergency Departments, and that the care of children features prominently.
“There’s a challenge in here for Emergency Medicine around looking at how they measure up to the blueprint, and around the potential reintroduction of short stay facilities associated with our departments, now named EEMAC facilities.
“We do have significant concerns about the lack of detail around the funding of urgent and emergency care in general, which is historically the poor cousin of elective care. There are also some concepts requiring careful evaluation alongside implementation, for instance the Mental Health facilities described.
“We will be interested to follow how the intent of this document is turned into implementation, and how outcomes will be measured and evaluated.
“We look forward to seeing how the workforce implications are brought into the 10-year workforce plan, given the emphasis on having senior decision makers in lots of different places within the blueprint. We know the presence of senior emergency physicians has a positive impact on patient care. We are certain this has been thought through.
“We also look forward to the investment in physical facilities that this blueprint will require, and to learning how EEMAC, for example, will be resourced and funded. It would be a shame to see this particular part of the puzzle unfinished.
“We hope this document will be just one of many chapters in a ‘Model Hospital’ novel and we look forward to working with NHSE and the government to develop other meaningful, tangible plans that will ultimately make more of a difference for both patients and staff.”