• Bolton NHS Foundation Trust is second most improved for Emergency Department 12-hour performance
• Between March 2024 and March 2025 Trust also in top ten for four-hour standard improvement
• Improvement work included a new Discharge Unit, reconfiguration of services and rapid assessments

Bolton has been named the second most improved NHS Trust in England for its Emergency Department 12-hour performance.

The hard work and dedication of urgent care teams has also seen the Trust become one of the top ten for most improved four-hour standard between March 2024 and March 2025, according to new figures from the National Urgent and Emergency Care (NUEC) team.

In late 2023, the Trust set out key areas of focus following recommendations made by the Emergency Care Improvement Support Team (ECIST), which included accident and emergency services, the flow of patients throughout Royal Bolton Hospital and discharging patients.

New ways of working

A number of new ways of working and clinical models were designed and successfully implemented as part of an urgent care improvement programme. These included:

• Working with North West Ambulance Service to prevent unnecessary attendances and prioritising the delivery of care in the community.
• An initial assessment and triage model to re-direct and stream patients to the most appropriate clinical setting. This reduces bottlenecks in the Emergency Department by ensuring patients are seen by the right clinician, in the right place, at the right time.
• Redesigning the configuration of urgent care services at Royal Bolton Hospital to help patients get to where they need to be sooner and reduce delays in the Emergency Department.
• Implementing proactive discharge planning on wards to identify patients who can go home and agree what actions must take place for that to happen.
• Opening a Discharge Unit to move patients from wards to a new comfortable environment while they wait to go home and creating a weekend discharge team to help people home seven days a week. This has resulted in increased weekend discharges by 72%.

Rae Wheatcroft, Chief Operating Officer at Bolton NHS Foundation Trust, said:

We’re very proud of the efforts of everyone who has been involved to get us to this place.

“Every percentage against a target is not just a figure; it’s a family that has had better care, a shorter wait, a loved one return home more quickly.

“Whilst it’s right we celebrate the progress made so far, we know the challenge now is to ensure we sustain these improvements into the future.

“In the coming months we’ll be implementing plans to ensure these changes are routed into the way we work to deliver high quality care for our communities.

The four-hour standard has been a cornerstone of measuring performance for over a decade and aims to make sure that patients are seen more quickly in Emergency Departments.

Trusts across the country, including Bolton, are working towards the ambition to improve to 78% of patients being admitted, transferred, or discharged within four hours of their arrival at the Emergency Department.

‘A collective effort’

Ryan Calderbank, Divisional Director of Operations for the Acute Adult Care Division at Bolton NHS Foundation Trust, said:

All of our teams should be incredibly proud of what we have achieved together in the last twelve months to improve urgent care services for Bolton.

“This work has been a collective effort across the organisation, and with Bolton system partners, to deliver these changes, and we are grateful for their commitment and hard work to successfully embed the changes.

Sam Ball, Programme Director for Operational Performance at Bolton NHS Foundation Trust, added:

We are thrilled our work and programme of change has led us to being named the second most improved trust in the country.

“The initiatives we have introduced are making a real difference to the care we’re able to provide to our communities, making sure they’re receiving the treatment they need at the earliest possible opportunity.

Staff will meet with the National Urgent and Emergency Care (NUEC) team on Friday 6 June to share details of their improvement work.