We take a system approach to identify and implement sustainable urgent and emergency care improvements.


We use our bespoke tools to diagnose the entire Urgent and Emergency Care pathway to understand drivers of poor performance and work with leaders to set priorities that will deliver the biggest impact for their organisations and the population.

Across the country, the health service struggles to deliver high quality and timely urgent and emergency care (UEC) services, particularly during the winter months. Last year (2017/18) was particularly challenging, with one in six A&E attendees spending more than 4 hours in A&E departments[1] and only 9 out of 137 trusts met the 95% 4-hour target in March 2018[2]

The successful delivery of operational delivery and transformational change requires local strengths in three areas:

  • systems and processes;
  • management and metrics;
  • leadership, culture and behaviour. 

Changing one without changing the others does not lead to sustainable change.

We have developed an Urgent and Emergency Care ‘Maturity Matrix’ assessment, in conjunction with a range of experts, incorporating best practice and our evidence library. The ‘Maturity Matrix’ is an online self-assessment that is completed by a range of staff across the health and social care system. The ‘Maturity Matrix’ results are used together with interviews, observations and data analysis to give a complete picture of the challenges facing local services, and some possible solutions.

We use our Demand, Capacity and Flow Tool to understand how demand, capacity and flow impacts adversely upon performance. This tool is used to reflect interdependencies by integrating data from across health and social care. Using a cloud platform, users can forecast demand, test different assumptions and track the impact on system performance.

Our analytics tools allow us to create one version of the truth that provides the basis for organisations to align behind actionable solutions. To facilitate this, we work alongside teams and use our Team Accelerator Questionnaire (TAQ) in collaboration with Heidrick and Struggles[3] to assess local ability to mobilise, execute, transform and operate with agility, and deliver coaching and improvement cycles to embed changes required. We deliver this support for teams critical to the success of an UEC system, including system leadership team, clinical leadership team, multi-disciplinary discharge team, ward-based teams etc.

We support systems to deliver the changes required on the ground, leveraging our extensive experience of working within the NHS to support our clients’ biggest improvement challenges. Our delivery support is tailored to our clients’ needs but involves:

  • Working alongside front-line staff to implement improvements through PDSA cycles
  • Support for clinicians and care professionals to embed clinically led changes
  • Support to prioritise the improvements that will have the highest impact relative to effort
  • Development of tools to track progress and impact of priority initiatives over time – utilising local and national benchmarks
  • Review and re-design of governance arrangements so oversight meetings have the right purpose, authority and tools to support discussion and to deliver actionable outputs
  • Development of improvement plans to address the key issues identified in the rest of our work.  

If you are interested about the work we do in our UEC service line, contact Anne or May for more information.


Anne Rainsberry           May Li

Partner                           Principal


Email Anne                      Email May





[1] Baker, C, NHS Key statistics, May 2018, House of Commons Library Briefing Paper number 7281 

[2] A&E Attendances and Emergency Admissions 2017-18, NHS England

[3]Heidrick & Struggles is a premier provider of senior-level executive search, culture shaping, and leadership consulting services.