Evaluating adult critical care transfer services across London

Adult Critical Care Transfer Services (ACCTS) were set up at pace during the COVID-19 pandemic to help move critically ill patients safely between hospitals.

As the immediate pressures of the pandemic eased, NHS England London Region commissioned UCLPartners to evaluate how the services had developed since March 2020 and what could be learned to inform future delivery.

Challenge

London’s five Integrated Care Systems had developed different ACCTS models, shaped by local need and the urgent circumstances in which they were created.

NHS England wanted a clear, independent picture of what was working well, where there were opportunities to improve, and how future services could be more consistent, equitable and sustainable.

What we did

We combined quantitative analysis with in-depth engagement to build a rounded view of the services. This included:

• reviewing two years of activity and transport data,
• mapping service configuration across the five ICSs,
• learning from other transfer services in London and across the UK.

We also carried out nearly 30 hours of semi-structured interviews with staff involved in delivering and supporting ACCTS. These conversations explored workforce, skill mix, logistics, equipment, patient and family communication, health inequalities, and how services worked with hospitals, ICUs, regional teams and other transfer providers.

Outcome

The evaluation provided NHS England London Region with practical insight to support future planning.

It showed that transfer activity has stabilised since the second peak of COVID-19, with fewer transfers for capacity reasons and more patients moved to escalate care or access specialist services.

It also highlighted variation in how services are configured across London, including approaches to time-critical transfers, staffing models, integration with provider services and capacity-related transfers. The work identified what is already working well, the challenges that need to be addressed, and a set of recommendations ranging from quick improvements to more significant changes in how services are designed and delivered.

By bringing together data, service mapping and frontline insight, UCLPartners helped create a shared evidence base for improving adult critical care transfers across the capital.