Tag: winter crisis

Health and social care crisis: Sturgeon and Sunak host emergency meetings

Clinical leaders, health experts and ministers will convene in Downing Street for an NHS Recovery Forum today. Scotland’s First Minister hosted a meeting of the Scottish Government’s Resilience Committee yesterday to discuss ongoing pressures on Scotand’s struggling health service.

In addition to his regular meetings on the health service, the Prime Minister will host the Forum to bring together experts from across the health and care sector to identify opportunities to go further and faster on improving performance and outcomes.

The Forum will major on four crucial issues: social care and delayed discharge; urgent and emergency care; elective care; and primary care.

Some of the best health and care minds in the country will use the session to share best practice and to understand whether any innovations developed at a local level could be applied to other regional areas or on a national basis.

As the Prime Minister set out in his speech earlier this week, innovation is at the heart of the UK government’s approach and will be a vital aspect of the solution, and so Forum attendees will include representatives from both the public and independent sector to ensure we’re harnessing a wide spread of expertise and talent.

The Forum is the next step in the significant action that the government has taken to improve outcomes and relieve the immediate pressures on the NHS and in social care caused by the pandemic, with further pressures due to the recent rise in covid and flu cases.

On improving capacity in the NHS, the government has provided an extra £500 million to speed up hospital discharge this winter and we’re also increasing bed capacity by the equivalent of 7,000 more beds.

The NHS is rolling out virtual wards across England, with an ambition to establish 40-50 virtual ward beds per 100k population, by December 2023. Virtual wards are where people, for example, who have acute respiratory infections can actually be treated at home with telemedicine or pulse oximeters and there is also a new fall service which can save about 55,000 ambulance call outs a year by treating people with falls at home.

In total, the government will invest up to £14.1 billion additional funding over the next two years to improve urgent and emergency care and tackle the backlog – the highest spend on health and care in any government’s history. £7.5 billion of this support is for adult social care and discharge over the next two years, which will also help deal with immediate pressures. 

91 Community Diagnostic Centres have been opened so far and they have delivered over 2.7 million tests, checks and scans to help diagnose patients earlier.

The government is also continuing to grow the NHS workforce, with around 42,000 more staff than a year ago, including over 10,500 more nurses and almost 4,700 more doctors.

The government is investing at least £1.5 billion to create an extra 50 million general practice appointments by 2024, while the NHS is accelerating the rollout of new state-of-the-art telephone systems to make it easier for patients get through to their GP surgeries.

Earlier this week, the Prime Minister set out one of his key promises that NHS waiting lists will fall and people will get the care they need more quickly. He also pledged to make sure the NHS is built around patients.

The Forum will run for the majority of Saturday and attendees will include chief executives and clinical leaders from NHS organisations, local areas and councils from across the country, clinical experts from Royal Colleges and independent sector organisations working with health and social care services to deliver services for patients. 

The Health and Social Care Secretary, the Chief Secretary to the Treasury, the Chancellor of the Duchy of Lancaster and Chief Executive Officer (CEO) of NHS England will attend the Forum.

A Downing Street Spokesperson said: “As the Prime Minister made clear this week, easing the immediate pressures whilst also focussing on the long-term improvement of the NHS is one of his key promises.

“That’s why we’re bringing together the best minds from the health and care sectors to help share knowledge and practical solutions so that we can tackle the most crucial challenges such as delayed discharge and emergency care.

“We want to correct the unwarranted variation in NHS performance between local areas, because no matter where you live you should be able to access quality healthcare.”

First Minister Nicola Sturgeon has chaired a meeting of the Scottish Government resilience committee (SGoRR) to discuss the response to ongoing winter pressures on the health and social care system.

In addition to the FM, yesterday’s meeting was attended by Deputy First Minister John Swinney, Health Secretary Humza Yousaf, other Cabinet ministers, and key partners from across the system including senior representatives from NHS Boards, COSLA, Integration Joint Boards and the Scottish Ambulance Service.

The latest situation with flu and COVID-19 infections was covered, along with the increased demands on acute sites and social care which have been experienced over the Christmas and New Year period.

A number of measures are being taken to alleviate pressures on the system, improve patient flow and ensure people receive the right care in the right setting. These include the use of Flow Navigation Centres as part of the redesign of urgent care, Hospital at Home and ambulance service staff providing treatment, where appropriate, to help avoid hospital admission.

The Health Secretary will update parliament at the earliest opportunity on ongoing work to support the system, and further resilience meetings will be held to monitor the situation in the coming days and weeks as required.

The First Minister said: “It is clear that health and social care is currently experiencing a period of intense and indeed unprecedented pressure. Staff are working exceptionally hard and have been doing so throughout the Christmas and New Year period.

“This comes after nearly three years of pandemic-related demands on the system, and we are all incredibly grateful to them for their efforts.

“I am clear that the Scottish Government must and will do everything it can to support our health and care service throughout the next few weeks. We remain in daily contact with Health Boards and there is already a huge amount of work being done, but we will leave no stone unturned to explore and implement any additional measures that could be taken to help alleviate pressures.

“With that in mind we will continue to work with all partners to implement actions that can help ensure the workforce is supported to deliver the high standards of care that we want everyone to receive.

“This will include actions to reduce unnecessary attendances at A&E – ensuring people get care in more appropriate settings, and those who need hospital care get it quickly, and also on effective discharge arrangements to reduce pressure on hospital occupancy. My thanks go to all those working incredibly hard across the whole health and care system during this period of exceptional pressure.”

NHS Confederation: Enact ‘Plan B plus’ to avoid stumbling into winter crisis

“The government should not wait for COVID infections to rocket and for NHS pressures to be sky high before the panic alarm is sounded”

Health leaders are calling on the UK government to introduce measures, such as mandatory face coverings in crowded and enclosed spaces, without delay to keep people well and avoid the NHS from becoming overwhelmed this winter.

The NHS is seeing worrying increases in coronavirus cases in its hospitals and the community at a time when it is preparing for a busy winter period, its staff are close to burnout, and it is being expected to recover many of its services that were disrupted by the pandemic.

The NHS Confederation is warning that the extent of this recovery could be at risk without preemptive action over winter from the government and the public.

Last month, the government set out its COVID-19 winter strategy, which focused on building the population’s defenses through vaccinations and other pharmaceutical interventions, as well as test, trace and isolate measures, and public health messaging.

Within that, a ‘Plan B’ would be enacted if pressures on the NHS were deemed to be at risk of becoming unsustainable. Additional measures could include clear communications to the public that the level of risk has increased, introducing certificates for people’s COVID-19 vaccine status, and legally mandating people to wear face coverings in certain settings, in addition to considering asking people to work from home if they can.

Many of these measures, particularly around mask-wearing and COVID-19 certification, are already common in parts of Europe where the prevalence of the disease is lower.

The membership body is calling for these actions to be introduced sooner rather than later so that if cases of coronavirus still rise to worrying levels, the government can then introduce tougher measures, if needed.

Alongside this, the NHS Confederation believes that this should go further with a ‘Plan B plus’, calling on the public to mobilise around the NHS and do whatever they can to support frontline services this winter. This could include:

  • Getting vaccinated, including booster shots when invited.
  • Turning up for scheduled healthcare appointments on time.
  • Using frontline services responsibly, such as by only calling 999 in emergency situations and accepting appointments with primary care professionals other than GPs, such as practice nurses and community pharmacists, as well as remotely from both primary and secondary care, if offered and suitable
  • Volunteering to support the NHS and joining or returning to the workforce, if eligible. 

Matthew Taylor, chief executive of the NHS Confederation, said: “The NHS has shown that it has been there for its patients throughout the pandemic and is working hard to tackle the increased demand for its services, with 1.1 million procedures and 25.5 million GP appointments delivered in August.

“The NHS is preparing for what could be the most challenging winter on record and it will do everything it can to make sure its services are not disrupted but these outside pressures are not solely within its gift to influence. As cases of coronavirus continue to climb, alongside other demands on the health service and pressure on staff capacity in both the NHS and social care, leaders are worried about what could be around the corner.

“There is a crucial opportunity for the public to pull together and show extra support for the NHS by behaving in ways that will keep themselves and others safe and also safeguard stretched frontline services for those most in need.

“It is time for the Government to enact Plan B of its strategy without delay because without preemptive action, we risk stumbling into a winter crisis. Also, health leaders need to understand what a ‘Plan C’ would entail if these measures are insufficient.

“The government should not wait for COVID infections to rocket and for NHS pressures to be sky high before the panic alarm is sounded.

“Additional investment has been given to the NHS to support its recovery and leaders are committed to putting that to best use as rightly, the public expects a return on its investment but if the government fails to get a grip on the rising cases of coronavirus and other illness, this could be put at risk.”

Confirmed cases of coronavirus in the UK have exceeded 40,000 for the last seven days, with 43,738 recorded yesterday and 49,156 on Monday. The last time cases were in this bracket was in mid-July.

Also, English hospitals have seen a 10% increase in Covid-19 cases in the last week, with 7,749 people reported at the last count. Deaths are averaging around 120 a day but today there were 223 deaths within 28 days of a confirmed positive diagnosis.

Vaccinations have played a significant role in keeping these numbers lower than they could have been and were in previous waves of the pandemic, with the NHS currently supporting booster shots and flu vaccinations to more patients than ever, as well as supporting Covid-19 jabs for 12- to 15-year-olds.

Over 83 million jabs have been given in England so far.

Royal College of Emergency Medicine: Winter crisis looming?

16,000 additional beds may be needed for the NHS to cope this winter

The NHS urgently needs a rapid increase in bed numbers if it is to meet potential demand this winter according to new analysis from the Royal College of Emergency Medicine.

The College’s new briefing document ‘RCEM Explains: Hospital Beds’ looks at how bed numbers have declined in the past decade, the impact of covid, and the potential number of beds needed this winter, based on previous levels of demand.

The briefing uses the ratio of emergency admissions to beds to model the numbers of beds that will likely be needed, based on the levels of demand seen each winter prior to the pandemic.

In the last five years in England this figure has fluctuated between 11.07 admissions per bed (winter 2015/16) and 12.50 (winter 2018/19). Excluding the most recent winters (both of which saw demand and capacity fall due to the pandemic), there was an average of 11.77 admissions per bed.

If the NHS is to achieve a similar ratio this winter, and there are a similar number of admissions as in the winter of 2017/18, the NHS will need just over 7,500 additional beds. If demand is similar to 2018/19, then this figure rises to 15,788 extra beds.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “We are currently seeing record levels of attendances at Emergency Departments and if this continues into winter – an extremely likely situation – the NHS will have too few beds to be able to cope.

“The consequences of having too few beds could be dire. If we do not have the capacity to admit patients into hospitals, then A&E waiting times will go up, patients will end up being treated in corridors – a very real threat to their safety before the pandemic, but now with the added risk of hospital acquired infection – and the elective backlog will grow further as beds earmarked for surgeries will be used for emergency patients.”

The briefing also makes clear the relationship between high bed occupancy and an increased rate of cancelled elective operations.

Dr Henderson said: “Too few beds means higher rates of occupancy, which in itself puts patient safety at risk, but it is clear that this has a huge knock-on effect on elective care. Lack of beds is one of the top reasons for cancellation of surgeries and if we do not address the shortage now, before winter, the elective recovery will fail.

“We know that access to services is an issue throughout the NHS at the moment with resources short all-round, but Emergency Departments act as the safety net for the NHS – if they cannot function properly the entire system stalls – so it is vital that the new Secretary of State does all he can to enable the NHS to expand hospital capacity. 

“The safe restoration of bed capacity to pre-pandemic levels is no easy fix though – as we’ve seen with the Nightingale initiative, capacity cannot be expanded if we do not have enough doctors, nurses, and clinicians.

“The capacity and staffing issues we face now have been over a decade in the making. Social care is still unfixed. Waiting lists are growing. Structural reconfiguration is in progress. Covid is less of an immediate threat but is unlikely to disappear. The Secretary of State has much to do, but he must start by making the beds.”