National planning for winter started earlier than ever before this year and significantly more resource has been devoted to it. Trusts tell us that this planning has been more extensive and more effective than ever before. The national bodies have been more joined up with the appointment of Pauline Philip as national director with responsibility for winter planning. 

Other significant steps include:

  • announcing an additional £335m in the 2017 budget to help the NHS to cope with winter this year
  • setting up a new national panel, the national emergency pressures panel, chaired by Professor Sir Bruce Keogh (former NHS England medical director), to provide independent clinical advice on system risk and an appropriate regional and national response
  • identifying which areas face the biggest risks this winter and supporting trusts and the wider system to respond promptly and safely
  • extension of primary care streaming: £100m was made available to help trusts redevelop emergency departments to incorporate primary care streaming so patients are treated in the appropriate setting
  • social care investment through the improved better care fund to reduce DTOCs: intended to free up 2,000-3000 beds
  • a joint emergency medicine workforce plan to increase the numbers in training and improve recruitment and retention.

Local systems have also been asked to develop escalation plans to ensure that safety is maintained during times of significant pressure. These include:

  • all patients who are to be admitted have a timely decision to admit to ensure they do not remain in the emergency department for any longer than is clinically necessary
  • patients are not cared for on hospital corridors
  • 12-hour trolley waits in the emergency department never happen
  • patients do not wait more than 15 minutes in ambulances before being handed over to the hospital
  • escalation beds have the necessary staffing and equipment to ensure safe care.