Evidence of SPC adoption is emerging in urgent care, but it is not yet embedded across the pathway

There are early signs that Statistical Process Control is starting to take hold in parts of the urgent and emergency care system. Some teams, through improvement communities supported by NHS England, are beginning to use control charts to monitor ambulance handovers, emergency department flow, and pressure points across the pathway.

This shift from static dashboards and retrospective reporting to a more dynamic approach is positive, though progress remains uneven.

SPC is being used, but not consistently

Where SPC has taken hold, it helps teams answer a question that traditional reporting struggles with: is what we are seeing normal variation, or is something actually changing?

In practical terms, this allows teams to:

· Differentiate expected fluctuations in ambulance handover times from genuine deterioration

· Identify whether changes in emergency department flow reflect stable patterns or require intervention

· Avoid overreacting to noise without missing real signals

The impact at the team level can be significant. Clinicians and operational staff gain confidence in their data and clarity in their decisions. However, because adoption often stays within individual teams or departments, variation continues to challenge the pathway as a whole.

What happens when only parts of the system use SPC

Applying SPC in only one area improves local visibility but does not stabilise the overall system. Individual services may appear stable, yet the pathway as a whole can remain unpredictable.

An emergency department may monitor its own variation while ambulance and community services use different metrics. Stability in one area does not ensure stability across the entire pathway.

This disconnect results in signals identified by one organisation being missed by others. Variation is managed locally, pressure shifts unpredictably between services, and escalation is often delayed. The system remains reactive, even when individual teams adopt more structured approaches.

The importance of a pathway view

Urgent and emergency care is not a series of separate components. It is a connected pathway that begins with community demand, flows through ambulance services and emergency departments, and continues into inpatient and community care.

If SPC is only applied at the edges, it cannot capture how that variation propagates. Early signals in ambulance demand may never be linked to downstream pressure in emergency departments. Changes in discharge rates may not be connected to handover delays.

Managing flow effectively requires a shared understanding of variation across the whole pathway, not just in the part that has invested in SPC.

Why adoption needs to scale

The current pattern, SPC used in pockets, is a natural starting point. Teams experiment, build confidence, and demonstrate value locally.

But it needs to go further. SPC applied consistently across ambulance, emergency department, inpatient, and community settings creates something qualitatively different: a shared view of variation that can be understood across organisations, where early signals in one part of the system are linked to downstream impact elsewhere, and where action is coordinated rather than isolated. Without that shift, the system remains only partially visible.

What leading practice is starting to show

A growing number of organisations are beginning to move in this direction, particularly in ambulance services where demand patterns and response times lend themselves well to this kind of analysis. Kensa Health Analytics supports organisations such as the National Ambulance Service (Ireland) and St John Ambulance New Zealand by applying SPC to operational data. Our work helps teams understand how demand, response, and handover performance interact over time, highlighting connections and potential intervention points throughout the urgent care pathway.

Central to this work is our tailored 72-hour modelling approach, which gives operational leaders a predictive tool to manage the four-hour emergency department standard. This approach identifies pressure points before they escalate and enables agile, system-wide responses.

This approach moves beyond static reporting, equipping teams to manage variation proactively and protect system stability.

Where Kensa Health Analytics fits

Kensa Health Analytics role is to facilitate system-wide SPC adoption, rather than isolated applications. We collaborate with urgent care pathways to integrate data from ambulance services, hospitals, and community providers, creating a unified, actionable view that highlights where variation and pressure may develop.

Our goal is to embed SPC at the core of system operations, ensuring the entire pathway can respond to variation and deliver stability and clarity, rather than isolated improvements. Unlock the full value of your pathway data. Contact Kensa Health Analytics to gain a comprehensive view and act with confidence.

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