ICBs have been told to ensure that patients with complex needs and long-term conditions are proactively identified and managed so that care is ‘optimised’ over winter.
In a letter to ICBs, NHS England outlined the steps ICBs need to take to provide care this winter.
It called for a ‘robust’ winter plan from all boards, including surge plans, and processes to report long delays and patient safety issues.
ICBs were also tasked with providing alternatives to hospital attendance and admissions and to work with community partners and local government to ensure patients can be discharged in a ‘timely manner’. It also asked for ICBs to promote vaccination uptake among underserved communities and pregnant women, as well as staff groups.
The letter said: ‘We recognise this winter is likely to see urgent and emergency care (UEC) services come under significant strain, and many patients will face longer waits at certain points in the pathway than acceptable.
‘It is vital in this context to ensure basic standards are in place in all care settings and patients are treated with kindness, dignity and respect.
‘This means focusing on ensuring patients are cared for in the safest possible place for them, as quickly as possible, which requires a whole-system approach to managing winter demand and a shared understanding of risk across different health and care settings.’
It added that NHS England would be convening risk-focused meetings with systems and expanding the operational pressures escalation levels (OPEL) framework to mental health, community and 111, and provide a more ‘comprehensive’ system-level understanding of pressures.
It comes after the Darzi report hailed neighbourhood working and multidisciplinary teams as the way forward for the NHS last week.
ICBs have been asked to:
- ensure the proactive identification and management of people with complex needs and long-term conditions so care is optimised ahead of winter:
- primary care and community services should be working with these patients to actively avoid hospital admissions
- provide alternatives to hospital attendance and admission:
- especially for people with complex needs, frail older people, children and young people and patients with mental health issues, who are better served with a community response outside of a hospital setting
- this should include ensuring all mental health response vehicles available for use are staffed and on the road ahead of winter
- work with community partners, local government colleagues and social care services to ensure patients can be discharged in a timely manner to support UEC flow
- assure at board level that a robust winter plan is in place:
- the plan should include surge plans, and co-ordinate action across all system partners in real time, both in and out of hours
- it should also ensure long patient delays and patient safety issues are reported, including to board level, and actions are taken appropriately, including involving senior clinical decision makers
- make arrangements through SCCs to ensure senior clinical leadership is available to support risk mitigation across the system
- review the 10 high-impact interventions for UEC published last year to ensure progress has been made:
- systems have been asked to repeat the self-assessment exercise undertaken last year, review the output, consider any further actions required, and report these back through regions
And on vaccination efforts, ICBs are asked to work with:
- local partners to promote population uptake with a focus on underserved communities and pregnant women
- primary care providers to ensure good levels of access to vaccinations, ensuring that plans reflect the needs of all age groups, including services for children and young people and those who are immunocompromised
- primary care and other providers, including social care, to maximise uptake in eligible health and care staff
Source: NHS England
