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The Keogh Urgent and Emergency Care Review

About the UEC review

Phase 1: development

On January 18 2013, NHS Medical Director Professor Sir Bruce Keogh announced a comprehensive review of the NHS urgent and emergency care system in England. This is one of the priorities in the planning guidance for clinical commissioning groups (CCGs), called Everyone Counts: Planning for Patients 2013/14 (PDF, 944kb).

Since January 2013, NHS England has been working together with expert clinicians, patients and delivery partners from across the urgent and emergency care system to develop an evidence base for change, and a set of principles to underpin that change. A steering group led by Professor Keith Willett, National Director for Acute Episodes of Care at NHS England, has taken this work forward.

From June 17 to August 11 2013, NHS England engaged with patients, the public, NHS staff and organisations on the evidence base and a set of principles for a change to the current emergency and urgent care system. 97% of respondents felt that the current system needed to change and two-thirds of respondents fully or mostly supported the emerging principles.

On November 13 2013, NHS England published its vision for urgent and emergency care, which was developed based on the previous engagement exercises.

Read the Urgent and Emergency Care Review: End of Phase 1 engagement report (PDF, 1.19Mb) for more details. The document highlights five key elements for change, which must be taken forward to ensure success: 

  1. To provide better support for self-care.
  2. To help people with urgent care needs get the right advice in the right place, first time.
  3. To provide highly responsive urgent care services outside of hospital, so people no longer choose to queue in A&E.
  4. To ensure that those people with serious or life-threatening emergency care needs receive treatment in centres with the right facilities and expertise, to maximise chances of survival and a good recovery.
  5. To connect all urgent and emergency care services together, so the overall system becomes more than just the sum of its parts.

The diagram below provides an illustration of what the system could look like if the five key elements are delivered and become reality (view a larger image of the proposed urgent and emergency care system).


Structure of potential new system envisaged by NHS England Urgent and Emergency Care Review


Click to view larger image of the proposed urgent and emergency care system



Phase 2: delivery

The second delivery phase of the review aims to convert the work done so far into a framework that will guide and support commissioners, clinicians and providers in the transformation of urgent and emergency care services.

Professor Keith Willett, National Director for Acute Episodes of Care, and Professor Jonathan Benger, National Clinical Director for Urgent Care, have led the second phase of the review on behalf of Sir Bruce Keogh. 

The work of this clinician group was then handed over to the Urgent and Emergency Care Delivery Group to work out the practicalities for changing of the whole system. In 2016, the Delivery Group was renamed the Urgent and Emergency Care (UEC) Development Group, to reflect its new position as a national stakeholder group. Its role is to deliver recommendations made by the Urgent and Emergency Care Review across England. The organisations represented in the Development Group possess the necessary tools, levers, expertise or influence to enact the change needed. Learn more about the UEC Development Group.


Phase 3: implementation

The UEC programme moved into its implementation phase in 2015. The focus was to establish a delivery mechanism for the objectives set by the UEC review and to roll out a range of interventions, which NHS England expects to positively impact patient experience and behaviour.

  • 23 UEC networks were established to harness expertise within local healthcare systems.
  • UEC route map was published in November 2015, which outlines expectations and timescales for implementation, national work programmes, and the expectations of UEC networks and their constituent CCGs.
  • Eight UEC vanguards were selected in July 2015, with the aim of improving the co-ordination of urgent and emergency care services, and reducing the pressure on A&E departments. Learn more about the role of vanguards.

 For more information, take a look at the latest news and progress reports.

Page last reviewed: 22/04/2016

Next review due: 31/07/2018