Urgent Care First - Powering NHS Recovery and Beyond

This is the first in a series of 3 articles written by CEO Conor Burke, setting out why urgent care is key to delivering the NHS 10-year plan.

Why urgent care reform is the most immediate and impactful route to delivering the NHS 10-Year Plan vision — and how UHUK is leading the way

Introduction: A system under pressure, a plan full of ambition

The newly launched 10-Year Plan for the NHS sets a clear, bold direction: prevention-focused, patient-centred, and delivered closer to home. It envisions an NHS that is digitally enabled, equitable, and neighbourhood led.

But to unlock this transformation, we must start with the system’s pressure point — urgent and emergency care (UEC).

Why? Because nothing works unless urgent care does. The UEC system is both a barometer and a bottleneck. If ambulances are queuing, A&Es are full, and patients can’t access urgent help quickly, the entire health and care system slows down and becomes unsafe — from elective recovery to primary care access.

At Urgent Health UK (UHUK) — the national membership body for social enterprise urgent care providers — we see a powerful opportunity: urgent care as the launchpad for reform.

Why urgent care is the first mile, not the last resort

In the popular imagination, urgent care is reactive: walk-in centres, 111, out-of-hours GPs. But it is actually the gateway to the NHS, handling tens of millions of contacts every year.

When urgent care is well-coordinated, well-led, and digitally connected, it:

• Eases pressure on A&E and General Practice
• Reduces unnecessary ambulance deployments
• Prevents deterioration that would require hospital admission
• Helps patients navigate the system appropriately — the first time

Yet, despite its centrality, urgent care is often treated as an operational stopgap rather than a strategic foundation. That must change.

The NHS Urgent and Emergency Care Recovery Plan (2025/26) sets immediate goals:

• Zero 45+ minute ambulance handovers
• Restore 4-hour A&E performance to 78%
• Scale Same Day Emergency Care (SDEC)
• Expand access to 24/7 urgent mental health support

These are vital. But if we stop there, we miss the bigger opportunity: using urgent care reform to accelerate the entire NHS transformation agenda.

The 10-Year Plan hinges on flow, access and digital front doors

The DHSC’s 10-Year Plan lays out ambitious goals, including:

·      Integrated neighbourhood teams offering urgent response, continuity, and prevention
⁠·      Digitally enabled access, with the NHS App as the “front door” to all services
⁠·      AI-supported triage, ensuring patients are navigated appropriately
⁠·      A focus on reducing unwarranted variation, improving outcomes, and tackling health
⁠ inequalities

None of these can be fully realised without a high-functioning urgent care infrastructure.  Here's why:

The Evidence for Reform: What smarter urgent care unlocks AI navigation and smart triage.

The Tony Blair Institute’s 2025 report makes the case for AI-enabled triage and navigation:

• 29 million unnecessary GP appointments could be avoided per year through better routing
• Up to £340 million annually could be saved by reducing inappropriate 111 and UEC contacts
• AI chat-based triage outperforms traditional symptom checkers in accuracy and speed

These tools can be embedded in the NHS App and/or NHS111 online, transforming them into a true digital front door that supports both patients and clinicians.

Ambulance and Flow Efficiency

Poor urgent care flow has a knock-on effect:

• 550,000 hours of ambulance time could be released annually by avoiding delays
• ⁠Unnecessary A&E attendances still account for 1 in 5 presentations
• Delays in urgent care increase the risk of avoidable death and harm in time-critical cases

Smoothing urgent care access improves response times, restores trust, and reduces the need for escalation.

UHUK’s Role: How mur Members are delivering this vision now

As a network of profit-for-purpose, mission-driven urgent care providers across England, UHUK brings unique value:

✔️ Community-Based, Integrated Provision
⁠UHUK members are embedded within ICSs and already deliver:

• ⁠GP in- and out-of-hours services
• NHS 111 and Clinical Assessment Services
• Urgent Treatment Centres and Urgent Care Hubs
• A&E front door triage and SDEC delivery support
• Remote monitoring and urgent care response services
• System wide urgent care navigation and care coordination 

✔️ Innovation at Scale
⁠Our members serve as innovation partners for ICSs, already
piloting:

• AI-assisted triage
• Real-time integration with NHS App
• Booking into urgent care via digital platforms
• Shared care records across urgent and community services

✔️ Social Purpose and Health Equity
⁠As social enterprises, our providers reinvest in local communities and have deep experience with:

• Language and access barriers
• Culturally competent care
• End-of-life urgent care
• Services for marginalised and underserved populations

We don’t just deliver services — we partner with systems and the community to design and then deliver what works.

Making it Happen - For ICS leaders and DHSC policymakers

1. Make urgent care performance a top ICS priority

• Incorporate ambulance response, 4-hour A&E metrics, and 2-hour community responses into ICS-level outcomes
• Fund performance improvement plans that incentivise and prioritise digital navigation, coordination, and same-day access

2. Invest in AI-enabled triage embedded in the NHS App

• Prioritise deployment of tools proven to improve accuracy and safety
• Ensure patient-facing triage connects directly to neighbourhood teams and UEC slots
• Monitor health inequalities in usage and outcomes

3. Integrate urgent care into neighbourhood models

• Include UHUK members in the development of integrated neighbourhood teams
• Commission 24/7 urgent care that blends virtual, in-person, and rapid response
• Align urgent care contracts with neighbourhood prevention and long-term condition goals

4. Support national procurement of interoperable urgent care digital platforms

• Enable real-time booking into UTCs, UCR and SDEC services
• Ensure access to Shared Care Records for all urgent care providers
• Build digital infrastructure that supports flexible deployment of urgent care staff and services

Urgent Care - The starting point of transformation

Too often, urgent care is treated as the sticking plaster - a quick fix, a workaround, a holding space. But in reality, it is the first test of every NHS reform ambition.

• You can’t have elective recovery without urgent care flow.
• You can’t have digital transformation without safe, accurate triage.
• You can’t have neighbourhood teams without urgent access built in.

Urgent Health UK believes that if we get urgent care right - truly right - we unlock the rest of the system.

We are ready to partner with DHSC, NHS England, ICSs, and local providers to:

• Prototype the next generation of urgent care access
• Scale innovation where it works
• Share learning from our national network
• Deliver real results for patients and communities

Conor Burke
⁠CEO - UHUK