Rishi Sunak has promised that the Government’s plan for emergency care will deliver “the largest and fastest-ever improvement in emergency waiting times in the NHS’s history”.

Speaking during a visit to County Durham, the Prime Minister pledged to fix ambulance delays and the crisis in A&E, though critics have said serious questions remain around the number of staff needed to improve NHS care.

As part of a new plan for improving urgent and emergency care, the Government has set goals that by March 2024:

– 76% of A&E patients will be dealt with in four hours. Currently fewer than 70% are and the official target is 95%.

– An average response time of 30 minutes for category 2 emergency calls such as heart attacks and strokes over the course of 2023/24. In December, patients waited over 90 minutes. The official target is 18 minutes.

Mr Sunak said his plan meant there would be more beds, more ambulances, more staff and better social care and “if we can deliver on it, I think we will see – in fact I know we will see – the largest and fastest-ever improvement in emergency waiting times in the NHS’s history”.

He added: “That is the ambition of our plan that we’ve set out today … I feel really confident we can deliver it.”

Mr Sunak said that with the “hard work” and the “ingenuity” of NHS staff “we’re going to fix this problem”.

He added: “We’re going to improve things for patients and make an enormous difference to people up and down the country.”

During a question and answer session with health staff, the PM defended not saying heart attacks and strokes must be responded to within 18 minutes this year.

I would love, nothing would give me more pleasure than, to wave a magic wand and have all of you paid lots more

Asked about ambulance waiting times, he said: “Of course it’s not good enough, of course, gosh, what happened in December was not great, it was not great for any of you working in the NHS, it was not great for patients.

“We will get back to 30 minutes over the course of this year and then we will get back to pre-pandemic levels thereafter, I would say that is ambitious.

“Starting from where we are, the scale of improvement will represent the largest and fastest improvement in NHS waiting times for emergency care on record.

“If we can pull this off, that’s what we’re going to do.

“The things we’re already doing, I think you will see, made a difference in January.

An important part of us getting a grip of inflation and halving it is making sure the Government’s responsible with its borrowing, because if that gets out of control that makes it worse and it’s about making pay settlements reasonable and fair

“I think you will see a difference in the January numbers compared to December because some of the things we did on discharge to move people out of hospitals have already started to have a bit of an impact.

“I think, hopefully fingers crossed, when the numbers come out for January you will see things are already starting to improve.”

When asked “when are you actually going to pay nurses properly”, Mr Sunak said: “I would love, nothing would give me more pleasure than, to wave a magic wand and have all of you paid lots more.”

But he added: “An important part of us getting a grip of inflation and halving it is making sure the Government’s responsible with its borrowing, because if that gets out of control that makes it worse and it’s about making pay settlements reasonable and fair.”

The new plan, which is not backed by extra cash, will see the NHS buy 800 more ambulances, open 5,000 new hospital beds and treat thousands more patients at home via video link in so-called ‘virtual wards’.

Health leaders will welcome the expansion of NHS 111 as a vital front door for children and young people with mental health concerns to get the support they need

It comes as NHS England announced plans to transform NHS 111 to take pressure off hospitals by increasing patient access to specialist paediatric advice for children.

The move will see some children referred directly for a same-day appointment with a specialist rather than attending A&E, with the aim of avoiding hundreds of unnecessary hospital admissions.

Both adults and children will also be given direct access to urgent mental health support across England with the hope fewer people will arrive at A&E in a mental health crisis.

NHS England said the plans will see an increased number of clinicians working across 111, including retired staff and returners.

NHS 111 will also be integrated into the NHS app with the aim of making it easier to use.

Furthermore, family support workers will be put in some A&E departments – with at least one in every region – to provide support to children with non-urgent issues and other support to families.

Workforce retention is key to making all of this work, because largely all the problems we see around NHS work and NHS crises, they’re related to workforce

Virtual wards will also be offered to more children.

Sean Duggan, chief executive of the NHS Confederation’s mental health network, said: “Health leaders will welcome the expansion of NHS 111 as a vital front door for children and young people with mental health concerns to get the support they need.

“Hopefully this will lead to earlier access to therapies and treatments, which in turn will reduce the number of people reaching a crisis state where they end up calling 999 or in A&Es with nowhere else to go, or worse.”

Speaking earlier about the Government’s overall emergency care plan, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said there was a “significant and dangerous crisis” in emergency care in December that must never be allowed to happen again.

Whatever service you're looking at, the one thing that's going to affect quality of care and access is the number of staff you have. So unless you've got a clear proposal for that as part of this plan, it's hard to see how it will have an impact very quickly

He praised some of the aims of the plan but said there is an NHS workforce crisis, telling Times Radio: “Retention is a big part of this. You can recruit as many junior nurses and doctors as you’d like but if you haven’t got the senior people to look after them and develop them, it’s actually quite difficult to get much out of them.

“The workforce plan has been written but it isn’t published and is separate to this… workforce retention is key to making all of this work because largely all the problems we see around NHS work and NHS crises, they’re related to workforce.”

Siva Anandaciva, chief analyst at health charity The King’s Fund, told the PA news agency on Sunday the proposals are “broadly sensible”, describing them as “the first real significant push to say we need more hospital beds in this country”.

But he added: “Whatever service you’re looking at, the one thing that’s going to affect quality of care and access is the number of staff you have. So unless you’ve got a clear proposal for that as part of this plan, it’s hard to see how it will have an impact very quickly.”