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Winter Preparedness

Volume 652: debated on Monday 7 January 2019

This Government recognise that winter, with demand placed on services with colder weather and seasonal flu, is a challenging time for the NHS as it is for health services around the world. DHSC Ministers meet weekly with our systems leaders in the NHS to ensure that our services are equipped for winter to support those who need them.

We have been busier than ever, but our NHS has been rising to the challenge over the festive period.

The latest data to November shows that compared to last year, we have seen 3.6% more attendances per day at A&E, and that over 1,600 more patients per day were seen within four hours so far this year. Despite that, the published NHS winter operational updates show that in December there have been fewer ambulance handover delays and diverts to other A&Es compared to last year. This means ambulances spend less time at hospitals and more time on the roads reaching patients.

Ahead of winter

We started the run up to the winter period with over 2,200 more doctors and 1,600 more nurses on our wards than just a year ago, bringing the total increase since 2010 to 16,500 more doctors and 13,400 more ward nurses

We also increased NHS funding by £1.6 billion at the start of this year, to support and improve A&E and elective care performance.

On top of this, in advance of winter, more than £420 million has been provided to help the NHS this winter:

£240 million for adult social care—allowing councils to plan to provide care for 40,000 more people.

£145 million capital funding to hospitals for winter improvements—to upgrade wards and redevelop A&Es—the benefits of which the NHS expects will bring the equivalent of an additional 900 beds.

£36.3 million has been invested into the ambulance services for new vehicles and ‘make-ready hubs’. This will pay for more than 250 new ambulances, with 100 delivered by Christmas Eve.

The NHS has continued to work to improve services in advance of winter, to help people avoid a hospital visit or admission, and get them home quickly if they do have to stay. This has included:

Increased access to GP appointments at the evening and weekends. The latest figures (August 2018) show that full extended access was available for 40 million people, which is an increase of over 4 million from March 2018.

Fully embedded clinical streaming in A&Es following our investment ahead of last winter of £100 million, which means patients are directed to the most appropriate service.

Improved NHS 111. Half of calls to NHS111 now receive clinical input and ahead of this winter we have rolled out 111 online across the country so that the public can access care advice and services through digital channels and reduce additional pressures on A&E. 91% of the population have access to NHS Digital’s 111 online service.

Work to standardise services provided by urgent treatment centres and increasing public awareness of this as an alternative to A&E for minor illness and minor injury.

Increased implementation of ‘hear and treat’ and ‘see and treat’ by ambulances—reducing unnecessary conveyance to hospitals.

Joint working between hospitals, councils and other local partners to reduce long lengths of stays in hospital and helping improve transfers to community and social care. The published NHS winter operational updates show that the number of beds occupied by patients staying more than 21 days in hospital on average per day is down by more than 2,000 (12.5%) this winter so far, when compared to the equivalent period last year.

Extending the flu vaccination programme—already the most comprehensive in Europe—even further. Vaccination remains the best line of defence against flu and this year, we have more effective vaccines available than ever before.

This winter we have also encouraged all healthcare workers to be vaccinated, are funding the vaccination again for frontline social care workers, and have extended the offer to staff giving direct care in the voluntary managed hospice sector. Free vaccine eligibility has also been extended to include children up to nine years old (Year 5) so that all two to nine year olds are now offered the vaccine.

Performance over the next few weeks

The NHS continues to make some progress in rising to the seasonal challenges, but we also know that there is no room for complacency at this early stage of winter.

There are clearly a number of hospital trusts where the situation has been challenging. The most recent statistics showed that 75% of all 12-hour trolley waits occurred in just 10 trusts.

In addition, NHS England and NHS Improvement continue to monitor NHS performance daily. They are supporting hospitals nationally and, working with regional teams, will maintain a close grip and oversight during winter of their performance.

The Care Quality Commission will be continuing to monitor hospital services over the winter months with over 30 visits to hospital emergency departments planned. The CQC is able to undertake further visits in response to any emerging risks identified.

And we will go further to support this through our long-term plan to guarantee the future of the health service—backed by an extra £20.5 billion a year in real terms by 2023-24.