3 reasons for optimism despite “year-round” winter pressures

Published: 27th June 2018

Nobody needs reminding that last winter put a strain on the NHS. But the story didn’t end there. The BMA warned back in April that the “new” winter crisis is the year-round crisis. Similarly, the HSJ reported on one struggling Trust that was keeping its winter beds open into the summer in anticipation of a continuation of the crisis.

As Chaand Nagpaul says, “These scenes have become an all-too-familiar occurrence, each year, stretching further into spring and appearing again earlier the next winter”. To quote a Trust COO, it’s not too difficult to imagine the waves on the beach staying long enough until they are just part of the sea – the crisis never abating.

Is it time to panic? In a word, no. Here’s why:

1. The problem is not quite what it seems

MORE people attend A&E in the summer. As QualityWatch reported in 2016, fewer people attend A&E in winter, with a defined clear ‘dip’ in numbers attending in December/January each year.  However, the number of older people going to A&E peaks in December and a greater number of people who attend in winter require emergency admission to hospital.

So the problem is different between the seasons – put simplistically, more people will show up at the front door in summer months but more people will need beds in winter. This means that a tough summer doesn’t necessarily herald a tough winter. Indeed, if a Trust makes great strides in reducing emergency admissions and bedstays, they may not see the real benefits until winter is here.

2. Money is coming

It doesn’t solve everything, but having money to throw at problems makes life a lot easier than not having money to throw at problems. And now, after years of belt-tightening, money is coming in the form of the £20bn 5-year spending increase promised earlier this month.

It’s not clear exactly when the money is coming or what conditions will be coming with it. Having said that, a number of senior people we know are expecting a short-term boost in the next month to coincide with the NHS 70th birthday on 5th July. It is our best guess that this will require an application for funding which includes a business plan, it may be prudent to get ready with a team or teams ready to write one.

If you get in touch with us, we can help you write a business plan for offering immediate Advice & Guidance across elective care, urgent care and Mental Health.

3. You can make changes that will impact this winter

There is a tendency for professionals working in healthcare to look at the scale of the challenges facing the NHS each winter and then to try and think of something else before their brains overheat! In management consulting there is a phrase about taking on a project that is simply too big to be effective or successful – it is “boiling the ocean”. Solving winter pressures in one go would be to try and boil the ocean.

Easier, then, to take bits of the ocean and boil them separately. You don’t need to solve everything at once, so focus on smaller areas that will make a difference and solve part of the problem. Leave other parts of the problem for another day.

Given the website that you’re on, it won’t surprise you when we recommend immediate Advice & Guidance to solve part of the winter problem. Giving GPs immediate advice on where to send patients they want to admit manages the numbers going to A&E whilst advice on how to treat those patients helps many patients avoid hospital altogether. It doesn’t solve the whole problem, but it solves a bit of it and has an immediate, measurable impact.

It also works in summer.

If you would like to discuss how immediate Advice & Guidance can help you manage demand for urgent care, elective care and / or Mental Health care, please get in touch to arrange a 30 minute phone meeting and demonstration on 01865 261467 or hello@consultantconnect.org.uk.

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For more information about how we work with commissioners, hospitals & mental health trusts to improve patient care, please get in touch.

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