Two Bradford health schemes are being highlighted as examples of how England’s urgent and emergency care could shape up under future changes.

The Virtual Ward system run at Bradford Royal Infirmary – which cuts hospital stays for elderly patients – and the way patients go online to help manage their own care at Phoenix Medical Practice, Allerton, have both been flagged up to illustrate the kind of proposals being put forward.

The first stage was published today of a blueprint report by Sir Bruce Keogh, the National Medical Director of NHS England, to reduce pressure on A&E and ensure people still get the rapid service they expect.

In the report, Sir Bruce proposes urgent but non-life-threatening cases should be dealt with in or as close to people’s homes as possible and that more serious or life-threatening emergencies, such as strokes and heart attacks, should be treated in specialist centres to maximise chances of survival and a good recovery.

Figures show nationally 40 per cent of A&E patients are discharged needing no treatment; up to one million emergency admissions could have been avoided last year, and up to 50 per cent of 999 calls could be managed at the scene.

The BRI’s Virtual Ward system began last October to get elderly A&E patients discharged quicker and avoid admitting them. Patients fit enough to go home are assessed in their homes instead of on wards to get the nursing and therapeutic support they need. The BRI has now cut its elderly re-admissions by eight to ten per cent the national figures are between 15 and 20 per cent.

At the Phoenix Medical Practice in Allerton, patients are able to make appointments, order repeat prescriptions and access their medical records online.

People with long-term conditions also use an online service called VirtuCare to see what impact their lifestyle factors are having on them which works well resulting in fewer A&E attendances and emergency hospital admissions for those patients, says Dr Shahid Ali.

Speaking about the report, Sir Bruce said: “A&E departments up and down the country offer very different services, yet they all carry the same name. We need to ensure that there is absolute clarity and transparency about what services different facilities offer and direct or convey patients to the service that can best treat their problem.”

However, he warned there was no simple solution.

“We will need different approaches in metropolitan, rural or remote areas. We know people will want to see change as soon as possible, but we need to ensure that there are no risky, ill-considered “big bangs”, and that there is a managed transition," he said, adding it could take three to five years for those changes to be made.