• NHS England and NHS Improvement publish review of winter 2016/17
• Report highlights pressures faced by trusts last winter and sets out recommendations to plan for upcoming winter
• We welcome report but reiterate call for targeted supported to allow the NHS to put extra capacity in place effectively

NHS England and NHS Improvement has published a review of how the NHS performed during winter 2016/17, and the action to help trusts prepare for this year’s winter.

It highlights the pressure that NHS faced last winter which led to:

• Bed occupancy levels and delayed transfers of care (DTOCs) at historically high levels
• Occupancy for Quarter 4 at 91.4%, and NHSI unvalidated daily sitrep data showed that on occasion this rose as high as 96.4%; and,
• Delayed transfers of care reaching their highest ever level in January 2017

The review sets out a number of recommendations for next winter which include:

• To ensure that there is enough system capacity to meet the pressures of winter.
• Better planning for peaks in demand over weekends and bank holidays
• Tackling significant variation in practice across the country which needs to reduce.

Responding to the review of winter 2016/17 published by NHS England and NHS Improvement, the director of policy and strategy at NHS Providers, Saffron Cordery, said:

“Last winter was very tough for the NHS. For short periods of time some local services were overwhelmed. Front line staff showed fantastic commitment and professionalism in response to growing pressures, but the situation was unsustainable.

“We led the calls for a winter review to ensure lessons were learned, and to help preparations for next time. We are pleased that NHS Improvement and NHS England have acted on those concerns. 

We led the calls for a winter review to ensure lessons were learned, and to help preparations for next time. We are pleased that NHS Improvement and NHS England have acted on those concerns.

“We support the broad conclusions of the report which emphasise the need to ensure there is sufficient capacity to cope with increased demand. They rightly focus on concerns about high bed occupancy rates, and delayed transfers of care (DTOCs) for patients who are ready to be discharged, often because of difficulties in lining up suitable social care.

“It is also right to identify and prepare for particular days – especially Mondays and holidays - when the pressures are likely to be at their greatest.

“Our recent Winter Warning report highlighted the importance of avoiding a narrow focus on hospital capacity, and ensuring we also invest in mental health, community and ambulance services as part of a wider programme to manage the extra pressures. Drawing on a survey and detailed discussions with trust leaders it found those from mental health and community trusts were particularly worried about their ability to meet winter demand. Those concerns are not sufficiently reflected in these recommendations. 

Time for action, including appropriate investment, is running short.

“In Winter Warning we called for an additional £350 million for targeted support to allow the NHS to put in place extra beds in community and mental health services as well as hospitals whilst also enabling the ambulance service to deal with more patients. 

“Trusts urgently need to know where they stand so they can plan properly and secure the extra staff cost effectively. Time for action, including appropriate investment, is running short.”