Concern about the impact of seasonal pressures over winter on your trust and local area

  • A large majority (87%) of trust leaders across all trust types said they were extremely concerned about the impact of seasonal pressures over winter on their trust and local area. 12% said they were moderately concerned and 2% said they were slightly concerned. Last year, 56% of trust leaders were extremely concerned.
  • Across different trust types, most trust leaders said they were extremely concerned. Both ambulance trust respondents reported they were extremely concerned (100%), followed by acute trusts (93%) and acute specialist trusts (86%).

What is your trust/local area doing to ensure you are in the best position you can be going into this year's usual seasonal pressures?

Trust leaders highlighted several strategies that their trusts/local areas are implementing to be in the best position possible going into this year’s usual seasonal pressures. The two major themes were winter planning and working collaboratively as a system. While these themes have been separated, many responses combined both strategies. Some respondents also noted a focus on staff wellbeing.

“Detailed winter plans are in place both as a system and as a trust, with primary and secondary care providers working together to minimise the potential impact of winter on the system…”

Combined acute and community trust, South East    

Trust leaders detailed the plans in place for the upcoming winter surge in demand. These plans mainly included recruiting additional staff, expanding and managing capacity, and promoting the flu and COVID-19 vaccination programmes.

“System wide winter planning underway - early; promoting uptake of flu and booster vaccination programme; supporting H&WB [health and wellbeing] of staff.”

Combined mental health / learning disability and community trust, North East and Yorkshire    

Trust leaders also emphasised the importance of working together as a system to manage demand through the winter season. This included sharing capacity, joint meetings, shared data and collaboration when planning.

“Collaboration between trusts has strengthened and both in acute and community/mental health service (MHS) plans are in place to help with known and expected pressures. For mental health this is primarily in children and young people (CYP) and adult acute services where beds are being shared to avoid out of area placements and to ensure adult acute resources such as psychiatric intensive care units (PICU) are shared when needed. In community services some bed contingency is there but workforce is a major concern”

Combined mental health/learning disability and community trust, London    

Over winter 2021/22 what do you see as the biggest risks to the services that you, or those in your local area, provide?

  • The biggest risk to services highlighted by trust leaders was staff availability, leading to workforce shortages. Some respondents attributed staff shortages to a short-term lack of availability due to sickness. However, many trust leaders reported long-term staff shortages as a result of burnout, lack of morale, and retention issues.

“Lack of available staff… Tired and demoralised workforce… Impact of seasonal illness and COVID-19 spikes on patient numbers and staff.”

Combined mental health/learning disability and community trust, South West    
  • Trust leaders also expressed concerns regarding increased demand and lack of capacity. The largest contributing factor reported by respondents to a potential surge in demand was the overwhelming presentation of COVID-19 and flu in addition to the need to provide elective care. Other trust leaders attributed additional demand to increased referrals and wider pressures across the health and care system, for example in primary care. Furthermore, respondents from mental health related trusts highlighted the increased demands on mental health services.

“Overwhelming pressure on the front door will significantly reduce elective capacity against a backdrop of the longest waits we have seen for some time…”

Acute trust, East of England    
  • The largest contributing factor reported by trust leaders to a lack of capacity was a concern over social care leading to an inability to discharge patients.

“Increased patients who are medically fit for discharge with a package of care but no residential or care home available.”

Community trust, South East    

“Increased patients who are medically fit for discharge with a package of care but no residential or care home available.”

Community trust, South East