Background
Accident and emergency (A&E) departments have not met the operational standard that 95% of patients should be admitted, transferred or discharged within four hours since 2014. Performance continues to be significantly below this standard.
The government published an urgent and emergency care recovery plan in 2023. The plan intended to improve A&E performance by, for example, increasing capacity through providing more beds, ambulances and same day emergency care services, as well as aiming to reduce demand by directing people towards alternative services such as 111. In June 2025 NHS England published an urgent and emergency care plan for 2025-26.
Scope
This study will examine the central oversight of local A&E services, tracing how people flow from A&E into the wider hospital and how this flow impacts A&E waiting times. We will look at the main barriers to the flow of patients through hospital, and how these barriers can be overcome. Our focus is on activities within the hospital.
We will consider how well placed the Department of Health & Social Care and NHS England are to improve the performance of A&E services, including:
- why efforts to improve A&E have not been successful
- whether current efforts are likely to improve A&E performance
NAO team
Director: Ashley McDougall
Audit Manager: Marisa Chambers