Winter

Concern about the impact of seasonal pressures over winter on your trust and system(s)

• Over nine in 10 trust leaders (96%) across all trust types said they were extremely (64%) or moderately (32%) concerned about the impact of seasonal pressures over winter on their trust and local area. 4% said they were slightly concerned. Last year, 95% of trust leaders were extremely concerned (72%) or moderately concerned (23%).
• Looking across different trust types, ambulance leaders were the most concerned, with 86% being extremely concerned, followed by acute leaders, with 72% saying they were extremely concerned. Leaders from mental health / learning disability trusts were also more likely to be concerned, with three fifths (60%) saying they were extremely concerned. Although leaders from community trusts were the most optimistic, as 45% were still extremely concerned and 55% were moderately concerned.
• Trust leaders provided various reasons for their concerns, including financial constraints and staffing provision. Several respondents highlighted the additional pressure being felt by community and mental health trusts as a knock-on effect from acute and ambulance services. Patient safety was mentioned as a key concern this winter given increasing demand and capacity constraints.

 

“We have been running hot all through the summer with reported escalations of higher morbidity in the community that we serve. We have seen a rise in Length of Stay which is then affecting our daily bed state. My concern is that we are going into the Winter period in an already compromised way.”

Combined Acute and Community trust, North East and Yorkshire    

“Summer acute demand means that winter will be especially challenging for the NHS alongside the focus on finance further restricting our ability to build capacity ahead of the period.”

Acute trust, Midlands    

Greatest risk to the provision of high-quality patient care over winter

• Over half of trust leaders (57%) said delayed discharges present a greater risk to the provision of high-quality patient care over winter.
• Social care was the second most common risk to the provision of high-quality patient care over winter, with almost half of respondents (49%) selecting this option.
• The third common risk selected by respondents was acute bed capacity with 43% selecting this option.
• Just over a quarter of respondents (27%) identified mental health services capacity as their greatest risk.

 

Please tell us what measures the trust, including with partners in your ICS(s), is taking to collectively manage the risks to patient safety this winter:

• The majority of measures reported focused on the flow and discharge of patients, alongside investing in community services to increase capacity. Some highlighted their work to strengthen virtual ward capability and capacity. To support system working, several respondents noted the increased role of provider collaboratives in information sharing and developing system risk escalation plans.