NHS likely to face worse winter than last year

The latest frontline intelligence has suggested that the NHS is on a trajectory towards a ’more likely worse’ performance this winter compared to last.

Following its winter warning publication in June, NHS Providers has published a report providing an update on the latest state of play on planning for this winter.

It found that despite better national-level planning and a lot of hard work by trusts, risk is growing rather than reducing. Failure to make the required investment risks worse performance than last winter, widely regarded to be the most challenging in recent times, NHS Providers said.

Evidence found by NHS Providers shows that although last winter was widely regarded to be the most challenging winter in recent times, the NHS is currently on a trajectory towards a, at best similar, but more like worse, performance this coming winter, with heightened patient safety risks.

It found that NHS system-level planning and support, led jointly by NHS England and NHS Improvement, is considerably more developed than last year and emergency care performance has been given greater priority. NHS Providers says extra social care funding should help reduce NHS delayed transfers of care, increasing NHS capacity, in about a third of systems. Trusts were found to be doing all they can to stabilise and improve their A&E performance in advance of this winter, in the face of demand increases and competing priorities.

However, evidence shows that these improvements are being significantly outweighed by a combination of increasing risks. Trusts are not consistently benefitting from the extra social care investment, as planned. Delayed transfers of care remain high, and demand is rising by around three per cent every year. Workforce shortages are growing, and primary and social care capacity, as a whole, remains very challenged. Trusts are under greater financial pressure than last year and therefore less able to afford extra capacity. Current emergency care performance is either worse or the same as last year, and trusts report that they do not have sufficient capacity to manage this coming year safely.

NHS Providers says an immediate emergency cash injection of between £200 million and £350 million is needed to manage this growing risk, but this must not be at the expense of existing expenditure on services that are key to winter performance such as primary care, community care and mental health care. It says the decision on the investment needs to be made immediately to ensure trusts have time to create the required extra capacity and minimise the amount spent on short term agency staffing fees.