Emergency care
Reporting on the state of emergency care
A survey by the CQC, in 2024, showed that many people were positive about their interactions with urgent and emergency care staff, but as the NHS has struggled through the Winter period, ambulance handover delays, ‘corridor care’, and a lack of pain relief have raised concerns.
There have been a number of reports, in recent months, which have highlighted the evolving state of emergency care, in 2024 and at the start of 2025. In this article, CSJ provides an overview of the key findings. A survey of more than 45,500 people who used
NHS urgent and emergency care (UEC) services in 2024 showed that many were broadly positive about their interactions with staff. However, a number faced lengthy waits to be assessed, and some were not given enough help to manage their pain or control their symptoms.1 Published by the Care Quality Commission
(CQC), the survey revealed the responses from patients who attended either a major consultant-led A&E department (Type 1) or an urgent treatment centre (Type 3) run directly by one of 120 acute hospital Trusts in England during February 2024. The majority of urgent treatment centre
(UTC) respondents were positive about their interactions with staff. Eighty per cent felt that the doctors and nurses they saw ‘definitely’ listened to what they had to say and most felt that they ‘definitely’ had enough time to discuss their condition and treatment (76%) with the staff treating them. People who had been seen at an A&E service
were less positive about their contact with staff. While 60% said they felt that doctors or nurses ‘completely’ explained their condition or treatment to them in a way that they could understand, over a quarter (28%) said this only happened ‘to some extent’ and 11% said it didn’t happen at all. Reflecting on their experience as a whole, more than a third of people (38%) who had attended a Type 1 department and over half (54%) of people who had visited a Type 3 department rated their overall experience as nine or higher out of 10. However, responses to questions about
specific areas of patient experience such as ambulance handovers, waiting times and pain management were less favourable. Of the 27% of survey respondents who arrived at A&E by
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ambulance, 61% said they were handed over to A&E staff within 15 minutes, but 17% reported waiting more than an hour. Over a quarter of Type 1 patients (28%) responding to the survey said they waited for more than an hour to be assessed by a nurse or doctor after arriving at A&E and 47% said they were not able to get help with their condition or symptoms while waiting. For those waiting in A&E only 26% were informed how long they would have to wait to be examined or treated - leaving 74% who were not. Notably, 64% of patients said they waited more than four hours to be admitted, transferred or discharged at A&E, and patients whose visit lasted more than four hours reported worse than average experiences for all areas of care analysed.
Of those attending a Type 3 department who had a pre-booked appointment, 64% were assessed within the 30-minute target. However, not everyone surveyed had an arranged appointment and almost one in 5 (19%) of those without an appointment said they waited more than an hour to be seen by a healthcare professional.
For people who needed help with medications
for a pre-existing medical condition while in the department, over a quarter of urgent treatment centre respondents (26%) and a similar proportion of A&E respondents (28%) said they did not receive that help. Less than half of people attending either an
A&E (42%) or an urgent treatment centre (47%) who needed help with pain relief thought that staff ‘definitely’ helped them control their pain. More than a quarter in both Type 1 (27%) and Type 3 (26%) services said they were not given any help with pain relief. The results also showed scope for
improvements at discharge. While two thirds of people discharged from A&E (67%) said they were given information on how to care for their condition at home, a third (33%) said they were not. One in five (21%) of people discharged from an A&E department said that they were not told who to contact if they were worried about their condition or treatment after leaving A&E. Of those respondents who felt they needed a conversation about any further health or social care after leaving A&E, 31% said staff did
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