What the NHS Urgent and Emergency Care Plan 2025/26 Means for Providers

NHS England's Urgent and Emergency Care Plan 2025/26, published in June 2025, set out a practical response to these pressures - seven measurable priorities for the 2025/26 winter period, backed by £370 million of capital investment. Now, as we move into spring 2026, the first winter performance data is in. Progress has been made in some areas, while others remain a significant work in progress. And with the Medium Term Planning Framework for 2026/27 to 2028/29 already published, there is now a clearer picture of what the NHS is asking systems and providers to deliver over the next three years.

Here is a summary of the plan, where performance currently stands, and what comes next.

The plan was published against a backdrop of sustained pressure across urgent and emergency care. A&E waiting time standards had not been met for over a decade. Category 2 ambulance response times had not hit their target for more than five years. Public satisfaction with A&E services had reached a record low.

At the heart of the plan was a recognition that many of the pressures on UEC stem from fragmentation. When services do not connect well, when data does not follow the patient, and when different parts of the system are not working from the same picture, the consequences are felt across the board. The plan asked the whole system - acute trusts, ambulance services, community providers, mental health trusts, ICBs and local authorities - to take shared ownership of improvement.

The plan set seven specific targets for the 2025/26 winter period.

1. Faster ambulance response times - Category 2 response times, covering patients experiencing a stroke, heart attack, sepsis or major trauma, were targeted to fall from 35 minutes to a 30-minute average across the year.
2. Resolving ambulance handover delays - A maximum 45-minute handover time was introduced. Meeting this standard was projected to free up 550,000 ambulance trips annually, with the longer-term ambition of reaching a 15-minute standard.
3. Shorter A&E waits - The four-hour standard was set at a minimum of 78% of patients being admitted, transferred or discharged in time, translating to more than 800,000 people a year receiving more timely care.
4. Mental health crisis care outside the emergency department - The plan committed £26 million to new crisis assessment centres and £75 million to eliminate inappropriate out-of-area placements by March 2027 - recognising that an emergency department is rarely the most appropriate environment for people in mental health crisis.
5. Getting people home sooner - Nearly 30,000 patients a year were staying more than 21 days beyond their discharge-ready date. The plan focused on discharge delays and better integrated working between health and social care, targeting the elimination of internal delays of more than 48 hours.
6. Faster care for children - Lord Darzi's report had identified more than 10,000 infants waiting over six hours in A&E, and the plan set an expectation of measurable improvement in children seen within four hours.
7. More care outside hospital - With at least one in five A&E attendances not requiring urgent or emergency care, the plan called for a significant expansion of urgent community response teams, virtual wards, and same-day emergency care (SDEC) centres, backed by £250 million to build around 40 new SDEC and urgent treatment centres.

As of the latest available data for January 2026, the picture is mixed - though there are genuine signs of progress alongside areas where the targets remain stretching.

On ambulance response times, the news is broadly positive. Category 2 response times averaged 30 minutes and 27 seconds across the April 2025 to January 2026 period, putting the system only slightly above the new 30-minute objective and significantly better than the position when the plan was published. Category 1 response times have also improved, with the 90th centile target met for the first time since June 2021.

A&E four-hour performance has shown improvement compared to 2024/25, with 72.5% of patients admitted, transferred or discharged within four hours in January 2026 - up from 61% in March 2025. However, this remains some way short of the 78% target set for March 2026, and 12-hour waits reached a record high of over 70,000 patients in January, reflecting the continued pressure on bed capacity and discharge pathways. Ambulance handover performance improved but has not consistently met the 45-minute standard, with ongoing variation across regions.

It is worth noting that winter 2025/26 saw record demand, with November 2025 recording the third highest number of ambulance incidents ever. The improvements achieved against that backdrop reflect real progress by NHS teams and systems.

Published in late 2025, the Medium Term Planning Framework for 2026/27 to 2028/29 sets a significantly more ambitious trajectory for urgent and emergency care. Category 2 ambulance response times are targeted to reach an average of 25 minutes by 2026/27 and 18 minutes by 2028/29. Ambulance handover times at hospitals are expected to reach an average of 25 minutes.

To support trusts in meeting these targets, NHS England published the Model Emergency Department guidance in February 2026. The document sets out the core principles and components of high-performing emergency departments, covering patient pathways, clinical streaming, and the operational standards expected across ED settings. It also includes detailed guidance on extended emergency medicine ambulatory care, with the aim of creating greater consistency in how urgent and emergency care is delivered across the country.

For 2026/27, a new payment model for urgent and emergency care is also being introduced, moving away from the block contract arrangements that have historically made it harder to incentivise the shift of care into community settings. A new ambulance service specification for 2026/27 has already been published, with an increased focus on clinical navigation, hear and treat, and see and treat approaches.

The framework also formally extends the neighbourhood care agenda into the longer-term planning cycle, with ICBs expected to develop plans for accelerating the left shift of care away from hospital settings. Community health services have a waiting time target for the first time, with 78% of activity to be completed within 18 weeks by 2026/27.

Running through both the 2025/26 plan and the Medium Term Planning Framework is a consistent need for better data sharing and interoperability. Ambulance crews being able to access patient records at the point of dispatch. Discharge teams having real-time visibility of social care capacity.

Community teams picking up early warning signs before a situation escalates. These are not abstract requirements - they are now funded commitments, with £20 million allocated specifically to the expansion of Connected Care Records for ambulance services, and a commitment to roll out the NHS Federated Data Platform to 85% of acute trusts by March 2026.

For providers, this raises practical questions about readiness:

• Can your systems share information across ambulance, acute, community, mental health and social care settings?
• Do your discharge processes give teams what they need to act without delays caused by information gaps
• Are your virtual ward and remote monitoring capabilities scaled to meet the expectations set for 2026/27 and beyond?

The plan and the framework both treat technology as a critical enabler rather than an optional add-on. Several areas are directly relevant for health and care technology teams.

Emergency department information systems - With NHS England's Model Emergency Department guidance now setting clear expectations for clinical streaming, real-time patient tracking and ECDS-compliant data capture, the technology running inside emergency departments is under greater scrutiny than ever.

Access Emergency Department (ED) is a cloud-native Emergency Department Information System designed to support NHS workflows and national data standards, giving ED teams real-time visibility of every patient across the department and ensuring mandatory ECDS data is captured accurately at the point of care. It is already in use at University Hospitals Birmingham, one of the country's busiest and most complex emergency departments.

Patient flow and bed management - Access Patient Flow Manager (APFM) provides real-time visibility of bed availability, discharge status and intended discharge dates is foundational to meeting both handover and discharge targets. This visibility needs to work across sites and settings, not just within a single ward or trust.

Interoperability across care settings - Shared care records connecting acute, community, mental health, ambulance and social care providers are central to the whole-system approach that both the plan and the framework demand. The Access Integrated Care Platform supports exactly this model and is already live across systems including MPFT and Shropshire Community Health NHS Trust.

Mental health crisis pathways - Diverting people away from A&E during a mental health crisis requires both the right clinical environment and the right digital infrastructure. Access to a patient's crisis plan at the point of dispatch, and the ability to route patients to the most appropriate setting, can directly reduce the number of mental health presentations in emergency departments.

Discharge planning and cross-sector working - Both the plan and the framework place joint responsibility on ICBs and local authorities for addressing discharge delays. Technology that bridges health and social care to enable shared visibility of discharge status, care package readiness and community bed availability.

Virtual wards and remote monitoring - For community providers, expanding virtual ward capacity is both an opportunity and an expectation in the medium-term framework. Remote monitoring tools that feed clinical observations back into the patient record and surface early warning signs are the clinical and technological backbone of this model.

The NHS UEC plan for 2025/26 set the foundations. The Medium Term Planning Framework raises the ambition considerably, with stretching targets for ambulance response, A&E performance and the shift of care into community settings over the next three years.

Winter 2025/26 showed that improvement is possible even under significant pressure. The trajectory is positive in several areas. The work now is to sustain and accelerate that progress, building the interoperability, community capacity and data infrastructure that the next phase of reform will depend on.

To find out how Access Health solutions support urgent and emergency care improvement, from patient flow management and virtual wards to integrated care records and mental health crisis pathways, get in touch with our team.