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The NHS has launched its 2025/26 Urgent and Emergency Care (UEC) Plan with a bold, system-wide vision to stabilise and transform frontline services ahead of winter with the ambition not only to deliver a better winter service for patients and staff but to lay the groundwork for long-term productivity and public trust in emergency services. 

The plan centres on three interlinked actions:  

• First, Integrated Care Systms (ICS) must focus collectively on the most impactful interventions to improve urgent and emergency care performance this winter. This includes reducing ambulance wait times, addressing handover delays, and tackling long stays in emergency departments.  
• Second, every ICS is required to develop and rigorously test winter plans that significantly expand urgent care capacity outside hospital settings.  
• Third, national improvement support and capital investment (totalling over £370 million) will be streamlined and targeted toward systems where it can deliver the greatest benefit. 

Driving change through winter preparedness 

At the heart of the plan is a commitment to deliver measurable improvements across ambulance response, A&E wait times, and mental health crisis care. Systems are being asked to eliminate handover delays, restore timeliness for Category 2 ambulance calls (targeting a 30-minute average), and ensure that at least 78% of A&E attendees are admitted, transferred, or discharged within four hours. Crucially, no patient should wait more than 24 hours in emergency departments for a mental health bed, and trusts must tackle delayed discharges, starting with the 30,000 patients who remain in hospital more than 21 days beyond readiness. 

Every ICS has been tasked with developing and testing a winter plan, to be signed off by leadership by summer 2025, covering discharge delays, vaccination uptake, flow through hospitals, and greater use of urgent care settings outside hospital. Plans must also commit to eliminating “corridor care” and provide clear improvement trajectories for ambulance handovers. 

Expanding community and virtual care 

The plan reinforces the Government’s third priority of shifting care from hospital to community wherever possible. With at least one in five A&E attendances deemed unnecessary, systems must expand urgent community response services, virtual wards, and Same Day Emergency Care (SDEC) pathways. Paramedics will increasingly operate under a “call before convey” principle, offering treatment at home when safe. Evidence from pilots in Hampshire and Kirklees shows these approaches can reduce unnecessary hospital visits by up to 80%.  

Data, digital, and performance management 

2025/26 marks a push to improve the digital foundation of UEC. The Connected Care Records programme will receive £20 million to ensure all ambulance crews can access real-time patient summaries across care settings. Additionally, the NHS Federated Data Platform (FDP) will be deployed to 85% of acute trusts by March 2026, enabling smarter forecasting, discharge tracking, and resource planning. 

New operational dashboards, improvement tools, and transparency measures will hold systems to account. High-performing sites will mentor those in difficulty, and national “one-team” support packages will intervene where progress stalls. 

Vaccination as prevention 

Prevention plays a key role in demand reduction. The flu and RSV vaccination programmes will be expanded, with new booking and walk-in services, and efforts to increase uptake among staff and children. All trusts must have staff vaccination plans in place by the end of Q1. 

Mental health integration 

Emergency departments are often the default setting for mental health crises. To address this, £26 million will fund new crisis assessment centres in systems ready to deliver by winter. A further £75 million will support local inpatient mental health capacity to reduce harmful out-of-area placements. Mental health providers will be held to account for reducing re-admissions and ensuring inpatient stays are as short as clinically appropriate. 

Improving hospital flow and discharge 

The plan sets a clear expectation to optimise flow through acute hospitals. Co-located Urgent Treatment Centres (UTCs) and expanded SDEC services will be prioritised through £250 million in capital investment. 

Systems must eliminate internal discharge delays beyond 48 hours and address long-stay patients using Better Care Fund capacity. Local success stories, such as Leicester’s high-dependency community care model, show how integrated discharge planning and appropriate step-down care can dramatically reduce bed days and costs. 

Conclusion: A call to action for leadership and collaboration 

Underlying this entire strategy is a call for resolute leadership. Trust boards, Integrated Care Boards, and local authorities must not only commit to ambitious goals but ensure daily, visible support to frontline teams. Performance variation and fragmented delivery models are to be replaced with aligned action and shared accountability. 

The NHS is treating winter 2025/26 as a proving ground, not only for patient safety, but for demonstrating that system reform that when change is driven by collaboration and data, it can yield results. This plan is not just about winter it’s about rebuilding the foundations of public trust in urgent and emergency care. 

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