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RCEM responds to The Hewitt Review

4 April 2023

Responding to today’s publication of The Hewitt Review: An independent review of integrated care systems by Rt Hon Patricia Hewitt, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said:

“We welcome the publication of The Hewitt Review and we are grateful to have been invited to contribute. The government must endorse this review and accept its findings and outline the 10 priorities for health systems, of which the recovery of Emergency Care must be one. National priorities will lead to better communication, collaboration and holistic working.

“An effective Emergency Care system is vital to the success of ICBs. This can only be achieved through whole-system efforts to work towards better flow throughout our hospitals. This effort must be driven by meaningful metrics and data. The four-hour target is important but the target of 76% as outlined by the government and NHS England is unambitious and will do little to drive improvements in patient flow and patient care. This target must be revised to a more ambitious and meaningful figure. With transparent data and meaningful targets, we will have greater clarity and understanding of the patient journey and problems of flow and delays to care. With a renewed and improved focus on the four-hour target in conjunction with the new 12-hour length of stay data measured from the time of arrival and national priorities for holistic working, we will be working towards eliminating delays to patient care and overcrowding.

“We welcome the recommendation around streamlining access to data across health systems. All data must be accessible, timely, relevant, and transparent. It is also crucial to have site-specific data to ensure site-level accountability. Aggregating performance figures for Trusts and ICBs may hide poor performance at a local level.

“We agree that prevention is crucial and welcome the increase in funding for ICSs by at least 1% over the next five years. However, prevention must not be equated to demand management, it is right for people to access care when they feel they need it. What we can do is prevent our most vulnerable or frail patients from requiring Emergency Care in the first place.

“This review is a step towards long-term planning and a long-term vision for the NHS and social care. We must see cross-party support as we work towards improving patient care.”

Responding the announcement by the Department of Health and Social Care that funding for the social care workforce will be halved, Dr Boyle said:

“At a time when this essential review is published which shows how much work there is to be done in integrated care, it is a shameful betrayal to learn that the government will be cutting millions from the budget pledged for social care. Quite simply you will not be able to do more with less. This will be a devastating blow for social care leaders and the social care workforce. The Emergency Care system hinges on an effective social care system; overcrowding and delays to Emergency Care are inextricably linked to inadequate and insufficient social care.”

Notes to editor

The Hewitt Review: An independent review of integrated care systems

Five priorities for UK Governments to #ResuscitateEmergencyCare:

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