NHS sets out plans for winter with new measures to help speed up discharge for patients and improve care

Care ‘traffic control’ centres to speed up discharge, additional ambulance hours and extra beds are part of wide-ranging plans to prepare for winter, the NHS will announce today.

The robust new measures, due to be set out at the NHS England board meeting in Birmingham today, will boost capacity and resilience across the NHS as well as building on the recent improvements in ambulance response times and A&E performance.

Winter preparations have been well underway since the publication of the NHS’s Urgent and Emergency Care 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.

The NHS will also be announcing a new scheme to encourage local teams to ‘overachieve’ on performance measures with financial incentives provided for these areas.

With more than 12,000 patients every day in hospital despite being medically fit for discharge, a nationwide rollout of ‘care traffic control’ centres will provide one stop 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 NHS, social care, housing, and voluntary services in one place to help make live decisions and offer patients everything they need in one place.

Around a quarter of local areas currently offer this service 12 hours a day, seven days a week and this is set to expand to every area of the country by winter.

Drawing information from electronic patient records to track patients and link up with housing services, it is expected a third of patients could be discharged using this model by December.

Chelsea and Westminster Hospital NHS Foundation Trust has been able to speed up and improve staff rounds and discharge patients more easily, using the Timely Care Hub where staff can track tasks and patient statuses live, and check information like anticipated discharge date and pathways. In future, the Trust will also be able to use the Timely Care Hub to check outstanding risk assessments for things like falls, infection control and pain assessment.

Patients at North Tees and Hartlepool NHS Foundation Trust in Teesside are benefiting from a new system which operates in a dedicated control room and tracks patients from admission through their hospital journey, highlighting in real-time any issues that could delay their discharge once they are medically ready to leave. Following a successful pilot, this system is now being rolled out around the country by NHS England.

At the monthly board meeting today, the NHS will also outline how it is bracing for another winter facing the possibility of higher than usual levels of respiratory illness including Covid, flu and RSV. Australia, whose activity often predicts what the NHS in England is likely to see in winter, is experiencing one of the biggest flu seasons on record with children particularly affected, making up four in five of flu-related hospital admissions.

The use of Acute Respiratory Hubs – where patients can get urgent same-day face-to-face assessment for conditions like Covid, flu and RSV will also be expanded to be available in every part of the country. Last winter, when first introduced, almost 730,000 patients used these services, helping to speed up access to care and advice while reducing wider system pressures.

With high levels of bed occupancy all year around, hospitals are putting more beds in place for patients and are on track to hit 5,000 additional ‘core’ permanent general and acute beds. Thanks to the efforts of the NHS, more than 99,000 core beds will be in place across the country by December 2023 – thousands more than last year, to boost resilience.

£250 million of funding has been invested since the UEC recovery plan was published to boost capacity and speed up discharge, with local NHS areas are on track to create an additional 900 beds. At George Eliot Hospital, the additional funding has been used to build two new modular wards and 60 new beds ahead of the busy winter months while Leicester is in the process of rolling out three new wards, a total of 76 new beds, to reduce overcrowding in A&E, cut ambulance handover delays and speed up response times for patients.

Earlier this month, the NHS announced its world-leading virtual ward programme would be expanding to children, with overall virtual wards bed numbers expected to hit an ambition of 10,000 by the end of September.

Local NHS teams will focus on preparations across a variety of services including mental health, with plans to be put in place to strengthen ambulance response to mental health calls, to raise the profile of all-age 24/7 urgent mental health helplines and to avoid long lengths of stay in mental health inpatient settings.

Sarah-Jane Marsh, NHS national director of urgent and emergency care, said: “Winter is always a busy time for the NHS and our teams are already under significant pressure – so today, we are launching a plan to further increase resilience across the country.

“Thanks to the hard work that goes on day in day out and the ambitious measures in our urgent and emergency care recovery plan, patients are seeing significant improvements in ambulance and A&E services over recent months.

“Ahead of winter we will not only have more ambulances and beds in place, but we will also be continuing to work more closely as an entire NHS and social care system, increasing the capacity of community services that help keep patients safe at home.

“We will continue to build on this progress and do everything we can to put the NHS on the front foot ahead of what has the potential to be another challenging winter with covid and flu.”

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 – this is both better for patients and for the NHS.

“Boosting the numbers of specialist hubs for patients with respiratory problems means patients can get seen quickly in their local community while also relieving pressure on hospitals.

“So while we know this winter is going to be a difficult one, it is important that the public play their part by using services in the usual way – using 999 in an emergency and primary care or 111 online for other health conditions.”

Health Minister Helen Whately said: “The government is working closely with the NHS and social care to prepare for next winter.

“Our Urgent and Emergency Care Recovery Plan, backed by record funding, has already improved A&E performance and ambulance response times. Thanks to that plan the NHS is getting 800 new ambulances, 5,000 extra hospital beds and 10,000 virtual ward beds.

“Getting ready for winter early goes hand in hand with cutting NHS waiting times – one of the government’s top five priorities.”

Matthew Taylor, chief executive of the NHS Confederation, said: “Health leaders will be grateful for the clarity this plan provides and will do all they can to help realise its aims, to build further capacity and resilience.

“The plan is based on sound evidence of what works, backed by data and learning from the last few winters. Its publication now, in summer, will give the health service a timely opportunity to prepare for what will likely be an extremely challenging winter.”

Miriam Deakin, director of policy and research at NHS Providers, said: “Summer is never too early to start planning and preparing for winter in the NHS. Every winter piles extra pressure on already stretched health services. Trust leaders will welcome national recognition of the need to boost capacity and resilience during what they expect to be another tough few months.

“Building on existing plans, trusts and system partners will seek to speed up discharge for those patients who no longer need to be in hospital, support ambulance services, bolster mental health and community capacity, alongside extra acute beds and virtual wards. With much needed funding and support confirmed today, measures to respond quickly to respiratory illness, including flu, Covid-19 and RSV- which proved so challenging last year- will help the NHS during the tricky winter months.”

Tracy Nicholls, CEO of the College of Paramedics, said: “This early focus on sustaining improvements in ambulance services is always welcome, and what is vital is that support goes out swiftly, wisely and consistently to ensure the inevitable increases in demand over winter are not able to take hold in the way we have seen over recent years.

“Expansion of the Acute Respiratory Hubs is welcome to enable access to specific treatment for conditions that affect so many patients at that time of the year.  Similarly, the ability to increase the Same Day Emergency Care capabilities will bring some relief to the system to prevent further pressure on hospital handovers and ED overcrowding.

“We do want to see a focus on children and young people, patients with mental health needs and those who are heavily reliant on social care services as these patients are always faced with challenges in getting appropriate access when systems come under increased demand with the burden often falling on paramedics and community care teams .

“We are pleased to see that there are plans to address these, and ICS’s must plan and commit early, and at pace to work closely with their system partners, particularly the primary and community care teams and the ambulance services so that measures are in place before we see the first signs of the inevitable winter pressures.

Jacob Lant, chief executive of National Voices, said: “Health and care services are still under huge pressure right across the country, and even with recent improvements in ambulance response times and A&E waits, patients and the public will want reassurance about how the NHS is preparing for the winter ahead.

“It’s therefore vital that NHS England are getting out early and showing the measures already being put in place, like increasing ambulance capacity, to ensure people can get the help and support they need. These efforts must continue over the coming months to ensure public confidence and help people understand what they can expect from the NHS this winter.”

Sarah Woolnough, chief executive of Asthma + Lung UK, said: “We welcome the news that winter planning for the NHS is already underway. For the 12 million people in the UK with a lung condition, such as asthma and chronic obstructive pulmonary disease (COPD), winter can be a dangerous time.

“Higher rates of respiratory infections such as flu and Covid-19, as well as cold air from plummeting temperatures can cause lung conditions to get worse and be triggers for life-threatening asthma attacks and COPD flare-ups – leaving people struggling to breathe. Additionally, hospital admissions for respiratory conditions are twice as high in winter as in the summer, accounting for a huge part of winter pressures on the NHS.

“If you’re eligible we strongly encourage people with lung conditions to get the flu, Covid-19 and pneumonia vaccines, as well as taking their routine medicines as prescribed and making sure their self-management plans are up to date with their GP. If you are worried about your symptoms or would like advice on what vaccines you’re eligible for, you can give our Helpline team a call on 0300 222 5800 (Monday-Friday, 9am-5pm).”