NHS ‘not sufficiently resilient’, says top medic as winter plans discussed

The NHS in England is “not sufficiently resilient” ahead of what could be a “difficult” winter, a top doctor has warned as health leaders were meeting to examine winter preparedness plans for the service.

Last winter has been described as one of the worst on record for the NHS, and Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said he feared the health service could face a similar situation this winter.

It comes as the Prime Minister and Health Secretary will meet with NHS leaders, top doctors and charities in Downing Street to discuss a number of proposals set to keep the NHS in England running smoothly as it expects an influx of cases of Covid, flu and other respiratory illnesses usually seen around the winter months.

Rishi Sunak and Steve Barclay
Prime Minister Rishi Sunak, right, and Health Secretary Steve Barclay were hosting a ‘winter roundtable’ with health leaders in Downing Street (Phil Noble/PA)

In an interview with the PA news agency, Dr Boyle, who will attend the meeting, said: “We remain concerned about how we’re going to be able to look after our patients this winter.

“We still have far too many patients spending too long, waiting to be admitted into hospital. This will inevitably cause problems with ambulance handovers and also the problems with people being looked after in corridors last winter.

“(Last winter) was extremely difficult and in terms of objective measures, it was the worst we ever saw.”

Asked if the NHS could see a repeat this winter, he said: “It is certainly a possibility. We still think our system is fragile and not sufficiently resilient to avoid a similar situation next winter.”

Dr Boyle said he would call for urgent action to tackle the number of people waiting for more than 12 hours in A&E.

The number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted was 23,934 in July, down 10% from 26,531 in June.

The figure hit a record 54,573 in December 2022.

The RCEM will also call for more to be done in terms of staff vaccination against flu and Covid.

Speaking ahead of the meeting, Prime Minister Rishi Sunak said: “This year we started planning for winter earlier than before. We invested in more beds, ambulances and discharge lounges through our Urgent and Emergency Care Recovery Plan, and we’re freeing up 15 million GP appointments through our Primary Care Recovery Plan.

“To drive forward that progress, today we’re bringing together the best minds in healthcare who all have one shared aim – protecting patients and making sure they get the care they need this winter.”

Health and Social Care Secretary Steve Barclay added: “Winter is always an extremely busy period and we’re working across the NHS to make services more resilient, ensuring those who most need help and support will get the care they need.

“I’m working closely with NHS and social care leaders to provide additional hospital capacity, protect emergency care and harness the full potential of technology to deliver the best possible service and intensify our efforts to tackle waiting lists.”

Earlier this year, NHS England announced plans for cash incentives for local hospitals who “overachieve” on performance measures such as A&E waiting times and ambulance handover times.

It also announced plans to introduce social care “traffic control centres” to help speed up hospital discharges so patients could be shipped out of hospitals when they no longer needed to be there.

When it announced the plans in July, health service leaders said that it was expecting this winter to be “difficult” for the health service.

These hubs, likened to travel agents for social care, will act as a single place for staff to co-ordinate the best and quickest discharge options for patients – either at home or into social or community care.

Other plans include having more ambulances on the road, extra beds in hospitals, a ramping up of the use of “acute respiratory hubs” and more “virtual ward” capacity.

Sarah-Jane Marsh, NHS England’s national director of urgent and emergency care, said: “The forthcoming winter will be another challenging one for health and social care, which is why teams across the NHS have been planning for this busy period since the start of summer, including getting more ambulances on the road and putting more hospital and virtual ward beds in place.

“Thanks to the actions taken, waiting times for ambulances and A&E services are lower compared to last year and the public can play their part over winter by accessing services in line with their needs – using primary care, pharmacy and 111 online or 999 in an emergency.”

Some 74.0% of patients in England were seen within four hours in A&Es in July, up from 73.3% in June. The figure hit a record low of 65.2% in December.

PA Graphics

The NHS recovery plan has set a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours.

The average response time in July for ambulances in England dealing with the most urgent incidents, defined as calls from people with life-threatening illnesses or injuries, was eight minutes and 21 seconds.

The Downing Street meeting comes after Healthwatch England said that more must be done to support people caught up in the record backlog of care.

Patients should get regular updates, health support and access to physiotherapy while on waiting lists, with medics ensuring they had appropriate pain relief, the patient champion organisation said.

A record 7.6 million people are waiting for treatment in England.

New figures on the waiting list are due to be published on Thursday.