Integrating Urgent & Emergency Care
The ambulance emergency and urgent care service specification
The purpose of the ambulance emergency and urgent care service specification is to set out the expectations for ambulance services in 2026/27. The specification has been designed for use by ambulance services and commissioners when commissioning the regional ambulance service.
The ambulance service is a statutory provider and is an important health resource for the population. For many people who dial 999, the ambulance service is often the first point of access to health care. The core function of the ambulance service is to provide an emergency response to those patients who have a life-threatening emergency and respond to major incidents. Ambulance services will also provide support to patients with urgent care needs, which may include directing them to a service that can best meet their needs.
NHS ambulance services are supporting the ‘left shift’ agenda; moving care closer to home, working within more joined up, person centred care in the community and reducing reliance on acute care. Ambulance services are supporting an increasing proportion (approx. 46 – 50%) of patients who have called 999 to be cared for at home, or within the community, because of the transformation and improvements they have delivered.
How regional ambulance services are integrating provision at all levels within their health systems – from national to neighbourhoods: implementing the 10-year plan
In response to the NHS 10 year plan, AACE has produced a comprehensive, holistic overview of its role in the plan’s delivery, and the associated enablers. AACE also developed the above graphic.
>> Read AACE’s full response here.
On 22 January 2025, the Association of Ambulance Chief Executives (AACE) was part of a group of six high-profile health bodies to jointly publish a new set of proposals for significantly reforming urgent and emergency care, to help inform the Government’s upcoming UEC Improvement Plan and 10-Year Health Plan.
>> Influential figures call for ‘single UEC service’ for NHS | News | Health Service Journal (requires subscription to HSJ)>> Exclusive: Expert review concludes NHS ‘got winter it prepared for’ | News | Health Service Journal (requires subscription to HSJ)
In March 2024, AACE co-published, with NHS Providers and NHS Confederation, a long-term vision for the ambulance sector. The vision provides the context within which we believe ambulance services can significantly contribute to improvement in urgent and emergency care provision across systems.
Following the election of the new Labour Government in July 2024 the Secretary of State for Health and Social Care (DHSC), Wes Streeting, commissioned a review of the NHS by Lord Darzi and used his report as a springboard for introducing change. DHSC, together with NHS England, have begun a widespread engagement exercise to inform the development of a new 10 year plan for the NHS.
Our feedback on behalf of all of our members into the review and the 10 year plan build on the sector vision developed earlier this year, and respond to specific questions asked. We will continue to engage with our members and partner organisations as the 10 year plan is developed and implemented.
>> Read our response to Lord Darzi’s call for evidence>> Read our submission to the ‘Change NHS’ 10 year plan
Collaboration with all partners, in secondary, primary, mental health and community, and our wider stakeholders in our communities, for the benefit of patients, requires greater integration of the urgent and emergency services we, between us, provide.
By acknowledging the potential for change and co-designing system UEC strategies with all partners and stakeholders, the ambulance sector can play a pivotal part in helping to alleviate many of the system pressures and capacity issues, rather than contributing to them.
AACE has been working with the NHSE Getting It Right First Time (GIRFT) team, who are also now working closely with the Emergency Care Improvement Support Team (ECIST) and the iUEC team.
In this Further Faster session (July 2024) we discussed:
- the interface between ambulance and hospital care,
- the impact of hospital handover delays on patient care,
- what the alternatives are to conveying patients to emergency departments (and the limitations of these),
- how we aim to get patients to the right care, first time when someone calls 999 and,
- how integrated care-coordination at the point of call is helping us to get it right with that single touch point,
- how we can identify where, if systems can address critical gaps in services, we can improve outcomes and experience for patients
Download the slide deck below:
