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NHS England Sets Out Plan for Winter Resilience

As the health service braces itself for another winter, NHS England said that extra beds, more ambulance hours, and care 'traffic control' centres, will be central to boosting "resilience" in the system.

Winter preparations were "well underway", according to NHS England, as it set out what it termed "wide-ranging" plans to improve patient care and "speed up" hospital discharges.

With more than 12,000 patients in hospital each day who are medically fit for discharge, health service bosses are hoping that a nationwide rollout of 'care traffic control' centres will give healthcare staff a place to turn to locate the best and quickest discharge options for patients. These 'one stop' centres will bring together teams from across NHS, social care, housing, and voluntary services to help make 'live' decisions, the plan envisages.

Around a quarter of local areas currently offer this service, and the plan was to expand this to "every area of the country" by winter, so that by December, a third of patients could be discharged using the model.

Dr Vin Diwakar, NHS medical director for transformation, said, "The rapid expansion of care traffic control centres means patients can be more easily discharged with the right support when medically fit to leave hospital, with the latest information available to staff in one spot".

NHS Capacity and Resilience

NHS England said it had begun work preparing for next winter as early as January this year, when its urgent and emergency recovery plan was published. That promised 5000 new and sustainable hospital beds and more than 800 new ambulances, including specialist mental health ambulances, with most scheduled to be on the road in time for winter.

Sarah-Jane Marsh, NHS national director of urgent and emergency care, emphasised that with healthcare "already under significant pressure", there was a need to increase "resilience" across the country.

The task ahead was illustrated this week when the hospital regulator warned that patients' experience of urgent and emergency care had deteriorated. The Care Quality Commission reported that waiting times of 4-hours or more in A&E had risen from 5% in 2018 to 17% last year.

Tracy Nicholls, CEO of the College of Paramedics, said that NHS England's "early focus" on sustaining improvements in ambulance services was always "welcome". She hoped it would mean that the "inevitable" increases in demand over winter were not able to take hold, as had happened in recent years. 

More Respiratory Illness Expected

This winter the NHS faced the possibility of higher than usual levels of respiratory illness including COVID-19, 'flu and RSV, NHS England warned.

A system of 'acute respiratory hubs' that were introduced last winter, where patients could get same-day face-to-face assessments, would be expanded to every part of the country, it promised. Sarah Woolnough, chief executive of Asthma + Lung UK, pointed out that hospital admissions for respiratory conditions were "twice as high" in winter as in the summer, and accounted for a "huge part" of winter pressures on the NHS.

A Sound Plan That Needs Funding

Miriam Deakin, director of policy and research at NHS Providers, said that "national recognition of the need to boost capacity and resilience" would be welcomed by trust leaders and would help the NHS during the "tricky" winter months.

Health and care services were still under "huge pressure right across the country", warned Jacob Lant, chief executive of National Voices. "Patients and the public will want reassurance about how the NHS is preparing for the winter ahead," he said, adding that "these efforts must continue to ensure public confidence, and help people understand what they can expect from the NHS this winter".

Matthew Taylor, chief executive of the NHS Confederation, said the plan was based on "sound evidence" of what works, was "backed by data and learning from the last few winters", and its early publication would give the health service a "timely opportunity" to prepare for an extremely challenging winter.

However, he was concerned there would be insufficient funding and staff to make the plan work. "We should be upfront that the financial settlement provided for the NHS, and required to effectively fund this plan, is not enough," he alerted.

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