Recipient organisationNIHR Midlands Patient Safety Research Collaboration
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Jul 2027
In plain English
AI plain-English summary
Rural and coastal A&E departments in England are running on models designed for cities, and no one has systematically mapped what actually works in these areas. The problem is that national NHS targets and recovery plans were built around urban hospitals with high patient volumes, nearby specialist centres, and short ambulance travel times—none of which apply to a community hospital in Cornwall or a coastal urgent care centre in Norfolk. This project will identify every innovative model of urgent and emergency care currently operating in rural and coastal England, then test which ones genuinely improve patient outcomes, reduce unnecessary hospital admissions, and make better use of stretched staff and resources. If successful, the findings could reshape how NHS England allocates funding and designs performance targets for the roughly one-third of the country that lives outside cities. The research may also produce new metrics—such as “transfer avoidance” rates—that better capture what good care looks like in places where the nearest major hospital is an hour away by road.
View original technical description
Background: Demand on Urgent and Emergency Care (UEC) services is felt throughout the NHS. However, rural and coastal communities face unique challenges. The importance of funding research and developing bespoke solutions to address health and wellbeing in rural and coastal communities has been identified as a national priority - Chief Medical officer’s 2021 annual report. We do not know how rural and coastal areas are responding to NHS England’s UEC recovery plan or how best to organise and deliver UEC care in these areas. Aims: To identify and evaluate innovative models of UEC in rural and/or coastal communities in England, including their impact on patient care, clinical outcomes, workforce and use of healthcare resources. Methods: The project consists of three work packages (WPs): WP1:A desktop review of organisational and policy documents, interviews with national, regional and local leads and stakeholders, focusing on rural and/or coastal areas. The output will be a national service map outlining UEC provision in rural and coastal communities. WP2:Using the national Emergency Care Data Set (ECDS) from NHS England, we will develop new bespoke ED performance metrics. We will use quasi-experimental to assess the impact of new UEC models (identified in WP1) on health and process outcomes, using standard metrics (e.g. admission rates, time to triage and discharge) and bespoke metrics (e.g. transfer avoidance, sensitivity and specificity of triage). WP3:Up to 12 case studies of UEC models in rural and coastal communities in England. We will interview and observe patients, carers, health care professionals within case sites. Personnel from other local health and care services (e.g. Ambulance staff, social care, primary care) will be interviewed but will vary according to UEC model composition. The output will be an in-depth understanding of how and why different UEC models influence patient clinical outcomes, experience, resource use and workforce.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know