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.

The pressures became so severe that trusts were asked to suspend planned operations by the National Emergency Pressures Panel (NEPP) and, in an unprecedented step, Care Quality Commission suspended routine inspections during January.  However, it was all too clear that, for many patients, the quality of care fell short of what the public rightly expects.

NHS Providers tracked the experience of the NHS in our Winter watch series and provided an overview in our briefing Mapping the NHS winter 2017/18. We showed how the pressures affected all parts of the health and care system and highlighted innovations and good practice that helped trusts deal with the exceptional challenges.

In this briefing we address key questions about the sector’s preparedness for this coming winter compared with last year. These include the operational and financial challenges trusts face following this summer’s heatwave, the support available from the national bodies, and the preparations trusts and their partners are making to meet the needs of their local populations in the coming months.

Our findings are informed by published national data and detailed perspectives from trust leaders as they steel themselves for the most challenging time of year.

Trusts are working hard to prepare for this winter. Welcome improvements have been put in place to help deal with the pressures ahead. However, weighing the likely impact of these improvements against the probable scale of pressures, we conclude that the coming winter will be more difficult than the last one for trusts, staff and for patients.