Urgent care components and their effectiveness: a rapid review

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Introduction

Demand for urgent and emergency care is rising worldwide. Emergency departments face longer waits and more patients, driven by ageing populations, chronic illness, and non-urgent visits. 

People often choose emergency care for convenience or reassurance, while urgent care services remain fragmented and unclear. This rapid review was conducted to explore current evidence and good practices from other countries to help redesign urgent care and meet growing demand in Wales. And to support Welsh Government plans to develop a new urgent care model that offers seamless advice, assessment, and care closer to home. 

This rapid review explored which components of urgent care services are most effective in reducing hospital demand and supporting care at home. 

The review highlights common service components used internationally and identifies those most effective in reducing hospital pressure and supporting patient independence. 

Main points

How up to date is this evidence?

We carried out the searches for this review in April and May 2025 and included studies published in English that evaluated data collected after 2015. 

What we found

We included 22 studies. No systematic reviews or Welsh-specific studies were found. Six key urgent care components emerged: access to radiology, digital triage, redirection tools, urgent care centres, task shifting, and virtual urgent care. Because all evidence comes from outside Wales, further research is needed to understand how these findings apply in the Welsh context. 

• Task shifting moves some urgent care tasks from GPs to advanced practitioners, such as nurse practitioners, to help manage rising demand and workforce shortages. Evidence from England and the Netherlands suggests this approach can work safely when supported by clear protocols and supervision. Studies report similar care quality and high patient satisfaction, but cost savings were small and uncertain, and more research is needed to confirm long-term impacts. 
• Access to diagnostic tests like X-rays is often limited in out-of-hours GP care, leading to more referrals to emergency departments. One study from the Netherlands found that giving GPs direct access to radiology reduced emergency department referrals for trauma cases. While this suggests better access could improve patient flow, the evidence is limited to one country. 
• Digital triage tools, such as NHS 111 and self-triage apps, help guide people to the right care and reduce unnecessary trips to the emergency department. Evidence from Belgium, Denmark, the Netherlands, Portugal, and England shows s mixed results. These tools can lower costs and make care more efficient, but their impact on safety and patient experience varies depending on how they are designed and staffed.  
• Redirection involves sending suitable emergency department patients to out-of-hours GP clinics to ease overcrowding. One low-quality French study suggests most patients accepted redirection and few returned to emergency department, indicating it may be safe and acceptable. However, satisfaction depended on available services, and evidence is limited to one setting. 
• Urgent care centres aim to reduce pressure on emergency departments by managing non-life-threatening conditions quickly. Evidence from five international studies suggests these can improve patient flow and reduce emergency department demand and may lower costs by avoiding unnecessary tests. However, most studies were small, single-site, and outside the UK, and findings on safety, waiting times, and patient experience vary.  
• Virtual urgent care uses video or online consultations to manage low-acuity cases remotely and reduce in-person visits. Evidence from Denmark and Canada suggests these can improve access and patient satisfaction and may lower costs when emergency department visits are avoided. However, findings on service impact and follow-up care are mixed. 

What this means

Urgent care services are under pressure, and this review highlights six components that could help: task shifting, access to radiology, digital triage, redirection, urgent care centres, and virtual urgent care. Each show promise for improving efficiency and reducing demand on emergency departments, but the evidence is mixed and mostly from outside Wales. 

These findings suggest that: 

• Multidisciplinary teams and clear protocols can support safe task shifting. 
• Better access to diagnostics may reduce unnecessary emergency department referrals. 
• Digital and virtual tools can improve access, but design and staffing affect safety and patient experience. 
• Service models like urgent care centres and redirection can ease emergency department pressure, but success depends on local infrastructure and patient awareness. 

Policymakers should consider these options when redesigning urgent care in Wales, while balancing safety, efficiency, and equity. Public awareness and inclusive service design will be key. Further research is needed to test these approaches in Wales, explore long-term costs, and ensure they work for all population groups. 

Technical information

We carried out a rapid review using streamlined methods to find and summarise evidence quickly rather than an exhaustive search. We included studies that looked at how urgent care components work in practice and measured outcomes such as safety, waiting times, cost-effectiveness, and patient experience. Although the focus was on urgent primary care, many studies combined urgent and emergency care. To reflect this, we included both.