Introduction

Rising risk and still no decision on winter funding

In June NHS Providers published its report – Winter warning: managing risk in health and care this winter – setting out how, last winter, NHS providers of all types struggled to keep pace with record levels of demand in the toughest winter of recent times. Our report highlighted the risks trusts face in preparing for the coming winter. Using the results of a survey of frontline provider trusts, we identified that:

• the £1bn of extra funding for social care in 2017/18, partly allocated to ease winter pressure in the NHS, is not reducing social care related NHS delayed transfers of care (DTOCs) as consistently as planned
• DTOCs (due to both social care and NHS issues) continue to take up NHS capacity unnecessarily. Taken together with other challenges, the NHS will therefore be some way short of the capacity it needs to manage the coming winter safely
• we estimated that an additional £350m was needed to create the required NHS capacity to manage risk this coming winter. We said this needed to be invested by the end of August to give trusts planning certainty and make the most effective use of the investment
• this is a whole system issue, requiring short and long-term solutions that involve every part of the provider sector and the wider health and care system.

NHS national leaders have made improving A&E performance a key priority this year, and local providers and systems have responded by putting huge efforts in to early resilience planning, alongside transforming urgent and emergency care pathways to improve patient flow.

However, as we embark on the final phase of planning for this winter, substantial risks remain at a local system level. If the health and social care system is overwhelmed this winter, patients will once again be put at risk as organisations will be unable to put in place the necessary capacity to meet demand. 

The only way to mitigate these risks is through an urgent NHS cash injection to ensure the NHS has the necessary capacity this winter to deal with heightened demand.