In the second article in our series on winter preparation, Kathy Oxtoby talks to Greater Manchester ICB about how it’s getting ready for busy season
NHS Greater Manchester has a ‘comprehensive, coordinated approach to winter pressures’, says Dr Manisha Kumar, its chief medical officer.
‘Escalation mechanisms and system coordination are in place with the GM System Coordination Centre providing intelligence, risk monitoring, and decision support.’
Vaccine strategy
This starts with a prevention plan, focusing on improving uptake of winter vaccines in line with national guidance.
Flu vaccine uptake decreased in 2024/25 across Manchester. Uptake of over-65s was 72%, down from 76% the previous year, and with under-65s at risk, uptake was 37.8%, down from 39.7%.
However, the aim for 2025/26 is ‘a 100% offer to all eligible patients and improved uptake across all cohorts’, says Dr Kumar.
Staff vaccination uptake will also be prioritised, and as updated advice from the JCVI has removed Covid-19 vaccination from frontline staff from eligibility, ‘our trusts will therefore prioritise the flu vaccine’, says Dr Kumar.
Executive and clinical leads will be assigned in all Trusts to oversee staff flu vaccination performance, with additional funding for initiatives aiming to achieve a 5% uplift in staff flu coverage, and a requirement to ensure the vaccine is offered to 100% of staff through on-site and roving clinics.
Performance will be reviewed every two weeks, she adds, with progress discussed through ICB performance meetings. Trusts are also encouraged to run data-quality checks on the Electronic Staff Record (ESR) to ensure accurate personal details link to the GP records figures ahead of the flu season.
Trust healthcare worker uptake will be reported from the federated data platform, which will be shared and presented to relevant performance meetings.
For patients, campaigns will be used to raise awareness about the importance of vaccination.
‘National investment in vaccination uptake campaigns gives us a strong foundation, but in Greater Manchester we go further – using our local insight to shape campaigns that resonate with our communities, reduce inequalities, and build confidence for people to protect themselves and their families,’ says Dr Kumar.
‘There will also be support for primary care – focusing on general practices with the greatest opportunity for improving uptake to enhance invitations and share best practice retaining a focus on reducing inequalities.’
In Greater Manchester, flu uptake in adults over 65 is 44% in Black, African and Caribbean groups compared to 75.6% White British.
‘Funding will be made available to local PCNs to improve vaccine access. Four roving vaccination providers will be commissioned to reach low-uptake areas, and there will be collaboration with the voluntary sector to build trust and provide translated materials,’ says Dr Kumar.
For childhood vaccination uptake, the new initiative where local community pharmacies will provide flu vaccinations for 2–3-year-olds, is also hoped to boost uptake, alongside a targeted school programme.
‘Low-uptake secondary schools will be prioritised with early-season clinics and catch-up sessions, and a dedicated officer, employed by Intrahealth, to improve uptake across all school-aged cohorts,’ says Dr Kumar.
‘There will be collaboration with local authorities to reach underserved groups, enhanced data oversight during flu season, and community clinics pre-planned for weekend/evening access,’ she adds.
Treatment initiatives
Across winter, Greater Manchester ICB will also be putting in place expanded services to help deal with demand. This includes a GM Clinical Assessment Service (CAS), Falls Lifting Service, and Acute Respiratory Hubs Service to reduce emergency department pressure.
‘We will be focusing on high-risk groups – older adults, children, ethnic minorities, and deprived areas. This will promote equitable access to diagnostics, rehabilitation, and vaccines,’ says Dr Kumar.
The ICB is also set to make use of the variety of services within primary care, including the Pharmacy First programme and the Greater Manchester minor ailments service.
‘We are encouraging emergency departments to make use of Pharmacy First, helping to direct patients into community pharmacy care where appropriate,’ says Dr Kumar.
The ICB also has a single point of access framework which supports access to community services as alternatives to A&E.
‘There is pre-dispatch triage, and pre-conveyance access for ambulance crews via a single telephony platform, so patients can be directed to the most suitable care, reducing pressure on emergency departments,’ says Dr Kumar.
Each locality is progressing towards unified triage models that include Urgent Community Response, Same Day Emergency Care, Hospital@Home, Urgent Primary Care, and Out-of-Hours services.
Additional winter services will also include more GP appointments, expanded mental health support including crisis offers, voluntary sector involvement, increased bed capacity, care home liaison, and improved emergency department streaming.
Workforce resilience
Alongside measures for preventing and dealing with extra demand, the ICB also recognises the impact on staff across the season.
‘Winter represents a particularly challenging time for our frontline NHS staff, with increased demand, higher rates of sickness, and pressure on services. Recognising the importance of workforce resilience, we monitor staffing levels monthly across substantive, bank, and agency staff, and actively manage sickness and temporary staffing through dedicated Staffing and Attendance Management Working Groups,’ says Dr Kumar.
‘Alongside this, we offer wellbeing initiatives and uphold the Good Employment Charter to support and retain our valued staff.’
In terms of industrial action preparedness, Dr Kumar says the ICB has embedded the learning from last year.
The System Coordination Centre ‘monitors pressure and informs mitigation strategies, supporting minimal disruption to patient care where possible’, says Dr Kumar.
