In this article, we explore NHS winter planning and the different challenges the NHS will come across in preparation for winter. Post-pandemic, the NHS is working hard to avoid a winter crisis.
As we head into winter, the NHS faces a renewed set of challenges, which NHS Chief Executive Amanda Pritchard claims are tougher than the pandemic. During a speech at the King’s Fund, she stated that when she took on the role in July of 2021, she thought that “the pandemic would be the hardest thing any of us ever had to do.” A statement followed by her admission that the greatest challenges may in fact be “where we are now.”
She went on to say that “It’s the months and years ahead that will bring the most complex challenges. I think it is harder now, because, partly, we no longer have a single unifying mission.”
But what are these challenges, and are they truly harder to handle for our health service than the pandemic?
A challenge that consistently presents itself within the system is the pressure on Urgent and Emergency Care. Following on from one of the busiest summers on record, based on the number of A&E attendances and urgent ambulance callouts, the department continues to provide care to approximately 500,000 patients every single week.
Another pressure upon Urgent and Emergency Care services comes from the significant wait times for treatment of mental health, with research suggesting that almost one in four patients are having to wait over 12 weeks to begin treatment. The study by The Royal College of Psychiatrists discovered that 43% of adults with mental illness say the long waits for treatment have led to their mental health getting worse and an increasing number are seeking help from urgent care.
Back before the pandemic, there were already significant shortages of hospital beds. Over the last decade, across the NHS and social care system, nearly 25,000 beds were lost. According to a report by The Royal College of Emergency Medicine, the loss led to a sharp rise in waiting times within A&E departments, ambulance services, and operations.
To further add to the issue, the COVID-19 pandemic has created an increased demand for beds, with COVID patients occupying approximately 3,000 beds over the past year according to Andrew Goddard, the president of the Royal College of Physicians. As it stands, the above-mentioned report states that the UK has the second lowest number of beds per 1,000 people in Europe, with current recommendations suggesting that at least 13,000 more beds are needed to combat the existing, unsafe bed occupancy levels and distressing waiting times.
Alongside this, data modeling around respiratory infections, including COVID-19, flu, and pneumonia, shows that they could create significant pressure in an already
challenging winter. Some predict that these illnesses could contribute to the occupation of as many as half of the beds in the NHS.
Recent reports have shown concerning trends in timings around ambulance response teams. To reference recent statistics from Shropshire Emergency departments, in the week leading up to October 27th, “four consecutive days saw patients waiting in the back of ambulances for more than 10 hours outside Royal Shrewsbury Hospital.” Within that same week, “ambulances spent a total of 562 hours waiting outside Shrewsbury.”
Matthew Taylor, Chief Executive of the NHS Confederation, said his members were issuing the “starkest warning about the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available,” a warning that is truly reflected in the numbers. Another recent statistic showed that paramedics in England had been unavailable to attend as many as one in six incidents in September due to being stuck outside hospitals with patients.
A final blow comes from what service leaders describe as “an acute lack of nurses” with 46,828 unfilled nursing roles across the NHS. In fact, across health and social care, roughly one in ten roles are vacant.
A number of reports have pointed to understaffing being the most predominant factor of all, as the lack of staff within the NHS prevents the service from addressing backlogs and improving patient care.
In a recent CQC report, Chief Executive Ian Trenholm stated, “People are stuck — stuck in hospital because there isn’t the social care support in place for them to leave, stuck in emergency departments waiting for a hospital bed to get the treatment they need and stuck waiting for ambulances that don’t arrive because those same ambulances are stuck outside hospitals waiting to transfer patients.”
It’s not difficult to see that NHS professionals are under immense pressure even before the above challenges come into play. These challenges are complex and will require many changes and continuous collaboration between health & social care providers to see change.
An existing focus toward improvement within the NHS is Digital Transformation and the integration of digital technology into all areas of an organization. Many Trusts have roadmaps towards their digital goals and undergoing digital transformation has several significant benefits, making information easier to access and supporting the collaboration between services being just two of them. In order to adapt to these modern challenges, strong digital solutions are essential.
The Cyferd solution aims to improve the understanding of patient needs and efficiently use digital solutions to allocate clinician time and improve community healthcare.
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