The NHS Confederation supports the principles of the Department of Health's (DH) consultation document 'Direction of travel for urgent care'. In particular we welcome the patient-focussed approach, the emphasis on integrated local solutions and the removal of any distinction in standards between in- and out-of-hours.

The DH consultation sets out a new definition of urgent care that addresses public and patient expectations of a 24/7, consistent and rigorous assessment of the urgency of their care need, and a prompt response to that need, without duplication or handovers from one part of the service to another.

We believe the challenge for the NHS will be to translate the document's principles into practical action. There are some national actions required, for example to accelerate the work on the future of Payment by Results to remove any perverse incentives around how urgent care is funded. We believe further discussion and evidence would be helpful on how far the system should be configured around patient culture and existing flows, and how far this can be influenced, for instance to only allow access to A&E departments through referral, not on foot.

We are concerned that the NHS should not have to wait for further detailed guidance on urgent care, but should be encouraged and be given the freedom to implement the principles of urgent care locally.

How we involve members in our work

We hold specific seminars and meetings to inform our policy positions - invitations either appear in our email bulletin Interchange Alert or are sent out individually. We have regular meetings bringing together key stakeholders with NHS Confederation members.

Confederation response

The NHS Confederation response to the DH's consultation document was submitted on 5 January 2007.

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