Standardising Assessment in the Emergency Department 

In 2022 NHSE started a project to standardise our measurement of acuity (sometimes called 'triage' and/ or 'streaming') in Emergency Departments and Urgent Treatment Centres.  

Achieving this would have significant benefits both to individual patients - to reduce risk of patients with serious conditions sitting in the waiting room for a long time undiagnosed. It would also have benefits to the wider system in that patient pathways could be standardised and training requirement reduced e.g. for staff moving between systems.  

At the start of the project, the Project Board commissioned The Strategy Unit (with partners, Crystallise) to perform a literature review. We were keen to ensure that we had scoped the existing practices - that we understood what systems of initial assessment were currently being used, how they worked and how strong the evidence base was, particularly with respect to patient outcomes and patient safety. 

The work was completed on schedule and within budget and has been particularly helpful in highlighting that while there were many publications in this area, there was not a current system of initial assessment that met accepted clinical standards for a solid evidence base of predicting patient outcomes and ensuring patient safety. 

The work by the Strategy Unit was effective in ensuring the national project we are now conducting to develop and pilot a national system of initial assessment has a solid intellectual foundation, and has also helped us understand what outcomes we should be measuring to ensure patient safety, and usability in practice.  

Dr Tom Hughes (OBE) and Sade Matakitoga 

NHS England