The coming winter is likely to be even more difficult than the last for trusts, staff and patients, warns a new report from NHS Providers.

Steeling ourselves for winter 2018/19 explores how resilient the sector is to the pressures it will face this coming winter. It welcomes improvements that have been put in place by trusts and the national bodies, but also highlights areas where the challenges for the coming winter are even greater than this time last year.

Last year NHS trusts and frontline staff made extraordinary efforts to maintain the quality of services for patients and service users through the winter in the face of a relentless rise in demand for care, compounded by the worst flu strain in seven years.

Steeling Ourselves welcomes improvements that have been put in place by trusts and the national bodies, but also highlights areas where the challenges for the coming winter are even greater than this time last year.

   

However, it was all too clear that despite trusts’ best efforts, for many patients the quality of care fell short of what the public rightly expects.

This report, based on published national data and detailed perspectives from trust leaders, says the challenges this winter are likely to be even more severe.

It sets out the balance of risks and benefits compared with 12 months ago. Factors pointing to better care this year include: 

• the impact of £145 million extra capital funding for buildings and equipment
• the recent announcement of £240 million extra funding for social care
• significant progress in reducing delayed transfers of care for patients who are ready to move on from hospital
• the potential for a less severe flu season

Factors suggesting winter could be worse this time include:

• continued acceleration in demand for care, significantly outstripping planning estimates
• worse A&E performance so far this year
• pressure across all other hospital activity restricting ability to prioritise urgent care
• greater pressure across mental health, community and ambulance services
• higher levels of staff vacancies
• more tired and pressured workforce making it more difficult than last year to fill extra shifts
• weaker state of social care, even when accounting for the extra £240 million, and more fragile primary care

The report concludes that forthcoming NHS long-term plan represents the best opportunity to break the recurring cycle of winter crises, and calls on NHS national bodies to acknowledge and plan for the true scale of extra, more complex demand that health and care services face.

It also says as trusts work to recover NHS constitutional performance standards they need will need adequate time and resources to get back on track.

And it calls for urgent steps to address immediate workforce problems, and measures to provide a sustainable long-term solution.

The deputy chief executive of NHS Providers, Saffron Cordery, said:

“Trusts and their staff put in extraordinary efforts last year to meet record demand, demand which continues to grow every winter. Despite measures to prioritise emergency care, it was clear that in many places the quality of care for patients feel short of what the public rightly expects.

“As attention turns to what this winter will bring, there are many improvements which have been put in place to welcome. Extra funding for capital projects and additional social care funding has enabled some trusts to better prepare and will provide some help in ensuring patients who don’t need to be in hospital have appropriate care at home or in the community.

“But there are clear warning signs. Performance is in a worse position going into this winter than last. Staff shortages are growing, putting additional strain on a workforce already overstretched during an exceptionally busy summer.

All things considered, trusts fear that this coming winter will be more difficult than the last.

Saffron Cordery    Interim Chief Executive

“The NHS remains under significant financial pressure with the additional funding announced by the prime minister only due to start flowing from next April. And the loss of dedicated winter funding has restricted what trusts can do to prepare for the most challenging time of the year.

“All things considered, trusts fear that this coming winter will be more difficult than the last.

We must escape the current and unsustainable cycle of severe winter pressures, which leaves the service playing catch up throughout the rest of the year.

Saffron Cordery    Interim Chief Executive

“We must escape the current and unsustainable cycle of severe winter pressures, which leaves the service playing catch up throughout the rest of the year. The long-term plan represents an opportunity to do this but we must be realistic about what resource is needed, and where it is needed, to meet future demand and recover performance.”