Will the new measures announced by NHS England do enough to protect the health service this winter?

NHS England recently announced a new package of measures which aim to “rapidly boost capacity and resilience through increasing bed availability and staff numbers.”

The new plans come following the latest NHS performance statistics. While the number of patients waiting more than two years for treatment has been virtually eliminated, there are still 350,000 people who have been waiting more than a year for planned care. Before the pandemic, less than 2,000 people had been waiting over a year for care.

• Further reading: Backlog of patients waiting more than two years for routine NHS treatment €˜virtually eliminated’
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To tackle the backlog and minimize the pressure felt across the health service this winter, NHS bosses have laid out the next steps to increase capacity and operational resilience in urgent and emergency care.

Ensuring patients get the care they need

Under the new plans, the NHS will increase the number of call handlers to 4,800 for 111 calls and 2,500 for 999 calls; create 7,000 general and acute beds (this includes physical beds and virtual wards); and work with social care partners to ensure timely discharge across acute, mental health, and community settings.

NHS leaders say they will also:

• Create an integrated Covid-19 and flu vaccination programme
• Scale up additional roles in primary care and release an extra £10m of funding to support mental health through the winter
• Better utilise urgent community response and rapid response services and the new digital intelligent routing platform, and improve direct support to the most challenged trusts
• Improve use of the NHS directory of services and increase provision of same day emergency care and acute frailty services
• Provide better support for people at home, including the scaling up of virtual wards and additional support for High Intensity Users with complex needs.

Professor Sir Stephen Powis, NHS national medical director said the plans will help the NHS to cope with the additional demand caused by “combined pressures from Covid and flu”.

He said: “Staff are already under pressure with continued high demand for our services – with figures showing the busiest summer ever for NHS emergency departments, with 2.18 million A&E attendances and almost 900,000 999 calls answered in June, and in July the highest number of category 1 ambulance callouts since records began.

“Ahead of the winter, we want to make sure we are doing everything we possibly can to free up capacity so that staff can ensure patients get the care they need €“ this includes timely discharge, working with social care, and better support in the community with the expansion of virtual wards.”

Workforce crisis must be addressed if measures are to have any real impact

However, health leaders are concerned that the measures will fail to have any measurable impact unless the NHS, together with the government, addresses the workforce crisis.

Sir Andrew Goddard, president of the Royal College of Physicians, said: “It is very welcome that NHS England is already preparing for winter by increasing capacity. But without any significant government intervention to retain and rapidly increase the workforce any plan will fall short. They all need people to deliver them, and it’s people we’re really lacking.”

Similarly, Professor Philip Banfield, council chair at the BMA said while the Association is pleased NHS England has listened to its recommendation to implement a directory of services to help patients determine whether they really need to go to emergency departments, what we really need is a “full complement of staff for the health service and patients to really reap the benefits.”

Professor Banfield added that without adequate staffing levels, plans to add more hospital beds, work more closely with social care and reduce wait times in emergency departments, will struggle to materialise.

“Making plans this early for winter is the right thing to do.  It’s a pivotal moment that NHS England has finally included mental health in their winter strategy, but we need to see the finer detail of how this plan will work and what it means for colleagues on the frontline.

“Frankly, it remains unbelievable that a credible longer-term workforce strategy – something the BMA has repeatedly called for – has failed to materialise. Staff are leaving in their droves as the pressures of working in the NHS become too much, and plans that only look ahead to the next few months are unlikely to encourage more to stay.

“The NHS is the people who work in it. The government must value them by providing comprehensive plans that deliver what is needed, not just in immediate future, but long after as well,” he added.

Government must provide additional support for GPs

The Royal College of GPs is also calling on the government to provide more support for general practice to ensure primary care practitioners can get through “what is likely to be a very tough period”.

This includes: immediate action to stop “unnecessary bureaucracy”, investment to support the rapid implementation of retention schemes available to those at high risk of leaving the workforce, and the expansion of coaching and mentoring services available to all individuals working in general practice.

In the longer term, the RCGP are asking the government to “heed the calls of our Fit for the Future campaign to address the spiralling workload and workforce pressures in general practice.”

“We want to see a new recruitment and retention strategy that goes beyond the target of 6,000 GPs pledged by government in their election manifesto, plus investment in our IT systems and steps to cut bureaucracy so that we can deliver the safe high-quality care that our patients need and deserve,” said Dr Gary Howsam, Vice Chair of the Royal College of GPs.

Investment in buildings and infrastructure is crucial to tackling waiting lists

The NHS Confederation is also urging the government to invest in hospital building and infrastructure after ministers admitted that 34 “hospital buildings in England have roofs made of concrete that is so unstable they could fall down at any time”.

In June, nine in 10 NHS leaders said their efforts to reduce the size of the NHS waiting list are being hindered by this lack of investment in buildings and infrastructure.

Rory Deighton, senior acute lead at the NHS Confederation, said it is therefore “critical” that the government provides access to capital funding.

“A failure to do so will continue to undermine the NHS’ ability to work efficiently and provide value for money to taxpayers despite the very best efforts of NHS leaders and staff,” he said.