From Crisis to Coordination: Making Neighbourhood Urgent Care Work

How a unified, localised model of urgent care can power the next era of NHS reform

Introduction: The urgent care conundrum

The NHS in England is under pressure from every direction — growing demand, complex needs, stretched resources, and widening inequalities.

At the heart of this challenge sits urgent and emergency care (UEC) — the system patients turn to when their need is greatest, but whose fragmented design often leaves them confused, delayed, or underserved.

If the 10-Year Plan is to succeed in its goal of more personalised, preventative, and locally delivered care, then urgent care must evolve from its traditional crisis-driven, fragmented structure into a coordinated neighbourhood-based model.

At Urgent Health UK (UHUK), we believe urgent care must now function as the central pivot of neighbourhood health — coordinating care across same-day access, virtual and physical responses, out-of-hours services, and digital navigation.

This is a vision that turns urgent care into a community stabiliser — connecting people swiftly to the right level of help, whether clinical, social, or emotional — and doing so close to home.

Why the current model isn’t working

Across England, urgent care is still largely commissioned in silos:

GP in hours response
NHS 111 call handling and clinical assessment
Out-of-hours GP services
Urgent Treatment Centres (UTCs)
Walk-in centres
Urgent Care hubs
Urgent Care Response services

These services often often operate independently, with overlapping scopes, inconsistent clinical models, and no unifying access route for patients.

Meanwhile, ambulance handovers, avoidable A&E attendances, and non-elective admissions remain high — because the system lacks clear, accessible alternatives.

Patients who are frail, in crisis, or unsure where to turn are often left navigating a maze.

The Vision: neighbourhood-based urgent care

The NHS 10-Year Plan calls for stronger neighbourhood health infrastructure: integrated community teams, digital navigation, prevention-first models.

But these neighbourhood models can only work if they include a clear, rapid response capability — i.e., urgent care.

UHUK proposes a shift from siloed services to local urgent care systems, built around the following design principles:

✔️ 1. One Entry Point

Patients should have a single digital and clinical front door — accessed via NHS 111, the NHS App, or directly by professionals — to all urgent care offers in their area.

✔️ 2. Local Coordination Hubs

Urgent care must be coordinated at neighbourhood level via integrated clinical teams — joining up virtual care, UTCs, out-of-hours GPs, UCR, and diagnostics.

✔️ 3. Virtual-Physical Hybrid

Urgent care should be delivered digitally where safe and convenient, and physically where needed — with rapid switching based on clinical need.

✔️ 4. Embedded in Neighbourhood Teams

Urgent care must connect directly into community services — including social care, mental health crisis teams, frailty hubs, and care homes.

Evidence and policy context

There’s growing evidence that better-coordinated, community-based urgent care reduces pressure and improves patient outcomes.

Key Insights:

NHS England’s 2025–26 UEC Plan calls for “urgent care front doors” in all systems and better use of virtual wards and urgent community response (UCR) teams.
The Tony Blair Institute shows that digital-first triage can divert millions of inappropriate contacts from A&E and GPs, while improving equity and access.
The Nuffield Trust and Health Foundation have shown that timely access to urgent community care significantly reduces emergency admissions, especially for older people.
ICSs implementing UCR with integrated digital triage have seen reductions in conveyances and faster crisis response.
Embedding same-day, out-of-hospital urgent care into neighbourhood teams supports both prevention and elective recovery.

These findings align perfectly with UHUK’s position: urgent care should be commissioned and delivered as an integrated neighbourhood function, not standalone services.

The role of digital and the NHS App

For this model to work, access must be digitally enabled, intelligent, and intuitive.

The NHS App is the ideal front door — but it must evolve to include:

Real-time booking into urgent care slots (virtual or in-person)
Smarter AI triage that considers local urgent care availability
Integration with neighbourhood teams and UCR services
Full read-write access to Shared Care Records for continuity

The Tony Blair Institute estimates that smarter triage tools, if deployed in urgent care first, could save £340 million annually, improve patient routing, and reduce the 29 million avoidable GP appointments every year.

UHUK members are already trialling this:

Embedding NHS 111 online into urgent care appointment systems
Piloting AI-enhanced digital triage
Linking urgent care with community diagnostics, virtual wards, and mental health response

UHUK in action: building neighbourhood urgent care

Urgent Health UK is a federation of social enterprise urgent care providers serving over 12 million patients annually. Our members:

Deliver NHS 111 CAS, UTCs, walk-in centres, out-of-hours GP, and UCR
Operate digital-first urgent care platforms with same-day and next-day access
Provide community urgent response teams that connect with primary care and acute partners
Are co-located with diagnostics, mental health, and social care in many systems

Real-world example:

In one ICS, a UHUK member runs a single urgent care service with the local NHS Trust that links:

111 online and telephone, CAS and GP out-of-hours
A physical UTC and virtual urgent care
Rapid response for frailty and end-of-life
Home visiting and care home triage

The result?

Fewer unnecessary conveyances
Faster care for housebound patients
85% of calls resolved outside A&E
Improved workforce satisfaction through team-based working

Recommendations for ICSs and policymakers

To embed this model across England, we propose the following actions:

1️. Commission “One Urgent Care System” at Neighbourhood Level

Bring 111, GP out-of-hours, UTCs, and virtual urgent care under one contract
Ensure services are coordinated in real-time by clinical leads
Fund care navigation and digital booking support for patients

2️. Prioritise Digital Integration with the NHS App

Ensure urgent care options are visible and bookable
Link AI triage to local urgent and neighbourhood services
Integrate with UCR and care coordination hubs

3️. Use Urgent Care to Power Population Health and Prevention

Embed urgent care data into population health platforms
Identify frequent users, clinical risk, and gaps in access
Link patients post-crisis to social prescribing and long-term support

4️. Leverage UHUK Providers as Innovation Testbeds

Commission UHUK members to pilot integrated models
Evaluate real-time outcomes across flow, equity, and workforce
Scale successful models nationally

Conclusion: From fragmentation to function

The NHS is moving toward a future built around data, prevention, neighbourhoods and choice. But unless urgent care is reimagined as a system of coordination — not a loose set of contracts — we risk repeating the mistakes of the past.

Urgent Health UK and its members are ready to lead the shift from crisis to coordination. We have the networks, the trust, the infrastructure, and the innovation to build a digitally connected, locally delivered urgent care system.

We call on ICS leaders, NHS England, and DHSC to:

Fund integration and innovation in urgent care
Commission one urgent care system per neighbourhood
Embed this system into digital, primary and community care reform
Measure success not by throughput, but by right care, first time, close to home

It’s time to move urgent care from a safety net to a neighbourhood nerve centre.

UHUK is here to help — with tools, pilots, and proven delivery.

Conor Burke, CEO, UHUK