In the face of sustained demand, constrained capacity and workforce pressures in UEC, the Getting It Right First Time (GIRFT) UEC team carried out a review of UEC services in England to understand the operational and clinical approaches that result in high performance.
A multidisciplinary team reviewed common themes across hospital sites and organisations, with a particular focus on alignment with the Model Emergency Department, the embedding of GIRFT’s clinical operational standards (COS) for emergency care pathways and initiatives for reducing corridor care in emergency departments (EDs).
Sites were identified for inclusion on the basis of being the highest performing in Q3 of 2025 across four-hour and 12-hour standards, ambulance handovers and corridor care levels, and the most improved between Q3 2024 and Q3 2025 against the same measures.
The resulting guidance highlights the findings of the review, pulling together the key characteristics of high-performing and most-improved organisations, and offering case studies and resources to support improvement on the themes of:
- leadership and executive behaviour;
- how the ED operates;
- specialties and inpatient areas;
- the acute medicine model;
- estate and workforce.
The guidance also contains a series of action checklists, allowing organisations to see what good looks like at a glance, and to support the development of improvement action plans.
