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14.12.16

Taskforce to support ‘high risk’ trusts failing to cope with winter pressures

Trusts at high risk of being unable to cope with winter pressures will be subject to special intervention, NHS England board papers show.

The Corporate and NHS Performance Report, published ahead of tomorrow’s board meeting, includes an update on action to cope with winter.

The Health Select Committee has warned that NHS providers should expect a “substantially more difficult” winter this year than previously because they are already coping with high levels of demand and funding pressures.

A review of all health systems in September, followed by a survey in October, has identified two lists of high-risk trusts – one for front door streaming of patients to ambulatory and patient care, and one for delayed transfers of care. However, NHS England did not disclose the names of the trusts on the lists.

These systems will be required to establish functional streaming and co-located services, and to agree ways to rapidly reduce delayed transfers with their partners. The report says that these systems will also be “subject to closer monitoring and intervention”.

A central team of leaders from trusts, CCGs and local authorities which have had success in reducing delayed transfers will work with eight of the systems to support them in this area.

Official figures show that delayed transfers have grown by 31% in the past year, in part because of problems with social care, but the National Audit Office estimates the actual figure could be much higher.

The NHS England papers also show that 111 providers have been set a new target of ensuring 30% of calls are transferred to clinicians, by recruiting new staff if necessary.

Furthermore, senior leaders will be kept on-call at national, regional and designated clinical officer level. The report says this will “provide crucial oversight” to the system in out-of-hours periods, and assure the government that the system is being properly supported. NHS Improvement is reviewing its on-call arrangements to better align them with the regulator.

Other measures for reducing winter pressures NHS England set out include:

  • Establishing national and regional ‘winter resilience rooms’, where NHS England and NHS Improvement staff will “collectively manage pressures as they arise”
  • Providing £10m for 882 vulnerable GP practices, £16m to strengthen resilience funding in 1062 practices, and £21m to improve access
  • Establishing a new urgent medicines supply route to divert 200,000 calls to NHS 111 from GP out-of-hours services to pharmacies
  • Running the ‘Stay Well This Winter’ campaign to encourage members of the public to get vaccinated for flu, and seek advice from a pharmacist at the first signs of a cold or flu

The papers also confirm that NHS England is still sticking to the target of encouraging providers to reduce their general and acute bed occupancy rates to 85%. A recent leaked memo revealed that trusts are being encouraged to use private care if necessary to achieve this.

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