Overview

East Lancashire Hospitals NHS Trust (ELHT) partnered with Strata Health to modernise how patients access emergency care by implementing a new urgent care model. By combining NHS England’s Streaming and Redirection product with Strata PathWays Digital ED, the premier BaRS-assured solution for referrals and appointment booking, the Trust has created a seamless, digitally enabled front door. This approach streamlines bookings and referrals between NHS 111, Emergency Departments (EDs), and Urgent Treatment Centres (UTCs), giving patients faster, clearer and more coordinated routes to care they need.

The Challenge

Emergency departments across England are under sustained pressure, with rising demand, overcrowded waiting rooms, and staff burnout. ELHT faced similar challenges, including difficulty meeting triage time targets and maintaining a positive patient experience.

The Solution

A Digital Front Door for Emergency Care

To address these pressures, ELHT implemented Strata PathWays Digital ED alongside NHS England’s Streaming and Redirection product. Together, these solutions create a fully integrated digital workflow that connects patients, referral sources, and care teams. By unifying bookings, referrals and streaming decisions across NHS 111 and Emergency Departments, ELHT has established a true digital front door that supports timely access, consistent triage, and coordinated emergency care.

How it Works

Multiple Access Points to Emergency Care

Patients can start their emergency care journey in several ways – online, by phone, or at the ED entrance:

  • NHS 111 Phone: Call NHS 111 to request an appointment.
  • NHS 111 Online: Book an ED appointment via the NHS 111 website.
  • NHS Streaming and Redirection product: Arrive at the ED entrance and use a digital self-assessment tool for rapid triage to determine the most appropriate care pathway.

Digital Referrals Sent to Strata PathWays via BaRS

Each access point generates a digital referral that is sent directly to Strata PathWays through BaRS integration. Acting as a central digital hub, Strata PathWays intelligently matches and routes patients to the most appropriate care setting, such as SDEM, UTC, ED, or an acute unit, based on clinical need.

Appointment Booking

Strata PathWays automatically books appointments, matching patients to the right time slots and locations. Teams and departments can add, adjust, or manage bookings as needed, ensuring flexibility and responsiveness. Administrators have flexible tools to configure complex appointment profiles, making it simple to coordinate multidisciplinary practitioner availability and reflect real-world working practices.

Patient Arrives for Scheduled Care

Once an appointment is booked, patients can bypass the ED front door and go directly to the right care setting at their scheduled time. On arrival, providers use system-supported assessments to quickly confirm needs and deliver timely, appropriate care.

EPR Integration

Patient and referral details are automatically added to the EPR system, ensuring continuity of care and comprehensive documentation.

The Workflow

Impact

The digital front door has reduced overcrowding, improved access, and enhanced experiences for both patients and clinicians.

Operational Improvements

132 hours/month of clinician time saved

48% reduction in waiting room volume

53% reduction in patient time spent in ED

Up to 75% of patients redirected or scheduled to return


Performance Metrics

August 2021August 2025
Total Attendance4,75910,655
4-Hour Performance87.71%94.88%
Average Time Spent in Department178 minutes94 minutes

Patient Feedback

“Was given an appointment for 2 hours later which meant I could go home and come back later rather than a lengthy wait in the waiting room. Really excellent service.”

“Your appointment system is fabulous it really works because you’re not waiting around for hours to see a doctor.”

“I thought the appointment booking service for A&E is an excellent idea it saves hanging around for hours, and the treatment I got was first class.”

Staff Feedback

“We’ve reduced the wait time in triage and reduced the wait to be seen.”

“A wonderful experience for the patient because they don’t have to wait in the department.”

“I’d never suggest a return to first come, first served.”

Scalability and Replication

Designed for rapid deployment, Strata PathWays Digital ED can be implemented in as little as 6–8 weeks, enabling Trusts to quickly improve flow, performance, and patient satisfaction.

Conclusion

ELHT’s transformation shows how a digital front door with real-time scheduling can modernise urgent and emergency care. By enabling appointment booking and safe redirection, Strata Health helped the Trust reduce crowding, improve efficiency, and deliver better experiences for patients and clinical teams. The model is scalable and ready to be replicated across the NHS.

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About Strata Health

Strata Health, a VitalHub company, delivers innovative digital solutions that support patient flow and care coordination across the NHS and other global healthcare systems. Our platform enables real-time visibility of care resources, intelligent matching, and seamless transitions of care between services. Tailored to meet the unique needs of UK regions, Strata Health supports integrated care pathways, reduces delays, and improves outcomes for patients and providers alike.

Take the first step down a better path with Strata Health Solutions. Contact us today.