By Sophie Coles
Winter pressures come as no surprise each year across the health and care system, but despite planning, services face considerable challenges.
Here at C.Co we believe it is essential that a ‘whole systems approach’ is adopted, ensuring that all parts of the system are actively involved in joint planning for winter and working together to support individuals who draw on care. As an example, greater emphasis on coordinating discharge well should be a key focal point for the system. Through maximising joint-working, the system optimises its combined resources, resulting in more optimal outcomes for those using services and those working tirelessly within the health and care system.
On 4th January 2023, the Prime Minister outlined his five key priorities for the UK in 2023; one of which was for NHS waiting lists to fall and people to get the care they need more quickly.
Last winter saw the NHS struggle with a 94.5% bed occupation rate, and 31.3% of ambulance handovers being delayed by 60 minutes or more. As a result, NHS England has proposed a range of measures to improve capacity as we move into the autumn and winter months.
On 27 July 2023, NHS England sent a letter to all Integrated Care Boards (ICBs) and NHS providers on the approach to winter planning and the key steps needed to deliver operational resilience across the NHS for the upcoming 2023/24 winter season. This is the earliest this letter has been sent out, reflecting the importance of early planning and the scale of the challenge experienced last winter.
Ten high-impact interventions to improve winter resilience
The letter set out 10 high-impact interventions to improve winter resilience and a set of recommended winter ‘roles and responsibilities’ across health and care organisations. The NHSE letter also asked systems to review their operational plans for winter and plan for surge scenarios.
Collaboration is crucial
Collaboration is crucial in ensuring that there are resilient plans in place across health and care systems for winter.
NHS leaders and ministers met in Downing Street late September to discuss planning for winter. The summit involved the Prime Minister, Health Secretary and Amanda Pritchard (Chief Executive of NHS England), with the focus being on what else the NHS needs to help it through the winter.
Winter preparations have been well underway since the publication of the NHS’s Urgent and Emergency Care (UEC) Recovery Plan, with over 800 new ambulances set to be in place to deliver over a million more ambulance road hours, as well as 5,000 more sustainable hospital beds and hundreds of new virtual ward beds each month.
With more than 12,000 patients every day remaining in hospital, despite being medically fit for discharge, a nationwide rollout of ‘care traffic control’ centres aims to provide an environment for staff to locate and co-ordinate the best and quickest discharge options for patients – either at home or into social or community care.
The centres will bring together teams from across the NHS, social care, housing, and voluntary services in one place to help make live, dynamic decisions and offer patients everything they need in one place.
Two key ambitions for UEC
NHSE states that all interventions over winter should contribute towards the two key ambitions for UEC performance of:
- 76% of patients being admitted, transferred, or discharged within four hours by March 2024, with further improvement in 2024/25.
- Ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24.
This is wholly dependent on the wider health and care system, as set out in the UEC Recovery Plan, including planned increases in social care capacity and improvements in access, and levels of flu and Covid being no higher than last winter.
Delivery over winter will require all parts of the health and care system to work collectively to deliver the system operational plan, and the high-impact interventions outlined in the UEC recovery plan.
In line with previous years, NHS England will be asking each system, led by ICBs, to develop a system-level winter plan, which outlines the steps that the system will take to deliver on respective actions, retain resilience, and manage a surge in demand above anticipated winter pressures.
With winter fast approaching, how prepared do you feel for the seasonal pressures now looming? C.Co understands the monumental system challenges that there are and we believe that all parts of the health and care system play a critical role over the winter period.