The NHS is creating "war rooms" to plan for what may be the toughest winter in its history. Health bosses have outlined "winter resilience plans", including new system control centres that will operate 24/7 in every local area.
The data-driven control rooms have been dubbed war rooms by the press, likening them to the Cabinet War Rooms at Whitehall used by Prime Minister Winston Churchill and other government ministers for strategic planning during World War II.
The new NHS action plan emphasises the serious situation faced by the health service as winter approaches. With a record seven million people on waiting lists, the NHS is also anticipating high rates of Covid-19 and flu.
How will the control centres work?
Teams of clinicians and medical experts will monitor the control centres in real time, assessing local NHS activity data and diverting staff and other resources to any hospital in danger of being overwhelmed to try and avert the crisis.
The new system also aims to improve the response times for frail and elderly people who have fallen at home - some have reportedly been left more than 24 hours after dialling 999. A rapid response team has been set up to help those who don't require hospital admittance, leaving paramedics to help the seriously injured and unwell.
Command centres will make fast decisions, including diverting ambulances to the nearest hospital where beds are free. NHS officials believe the new winter war rooms can help free up around 55,000 ambulance trips per year.
New "hubs" for respiratory infections
In addition, local medical hubs will be established to treat patients with respiratory infections, such as pneumonia, Covid-19, flu and acute bronchitis. The aim is to keep as many as possible out of hospital, after reports estimated up to 50% of all hospital beds could be occupied by people with respiratory infections this winter.
Respiratory infection hubs are to be based at health centres and walk-in clinics. Patients will be referred by a specialist. The aim is to prevent waiting on A&E trolleys for an excessive amount of time - the number of patients waiting for more than 12 hours on a trolley before a decision on whether to admit them was made rose to a record 32,776 people in September.
Only 71% of A&E patients were seen within four hours - the joint worse statistics since records began. Operational standards require at least 95% of people to be admitted, discharged or transferred within four hours. This target hasn't been met since 2015 due to staff shortages, followed by the pandemic.
Covid and flu "twindemic" fears
Amanda Pritchard, the chief executive of NHS England, said the combined impact of Covid and flu, together with record NHS staff vacancies, means we were facing a "twindemic" this year. The NHS was "going further than ever before" in anticipating the busy winter.
She believes every new initiative will make a real impact at ground level by helping to relieve the pressure on frontline staff. Patients should be seen faster and directed to wherever they will receive the best care. Additional hospital beds will be freed up, including those that were previously "mothballed".
The new 24/7 data-driven war rooms will continuously track beds and attendances. It will enable all NHS activity and performance to be reviewed simultaneously in one hub for the first time.
The NHS says currently, more than 10,000 patients ready to leave hospital are having to remain there because social care issues are blocking their discharge. This is further preventing new patients from being admitted.
Health chiefs are trying to avoid the system being further overwhelmed when winter flu and Covid victims start taking up more beds.
How will it impact carers?
The plan includes a "community-based falls response service" for people who have fallen either in their own home, or in care homes, to reduce unnecessary ambulance callouts when people are uninjured. Currently, elderly fall victims are usually taken to hospital as a precaution.
No research has been published to date on the impact the community-based system will have on care home staff or carers who look after a member of their family at home.
Under Boris Johnson's government, the Health and Social Care levy, launched in April 2022, was aimed at pumping extra money into the social care system through people paying more National Insurance contributions. However, Liz Truss scrapped the scheme.
From 6th November, the temporary 1.25% NI rate increase is being reversed. In addition, plans to introduce a separate Health and Social Care tax in April 2023 have also been cancelled. The financial and practical impact of this on care homes and carers in the community has not yet been published.
How serious are flu and Covid hospital admissions?
In winter 2021, hospital admissions and deaths due to Covid-19 were higher than those caused by flu and pneumonia. Scientists say Covid-19 spreads faster than flu and there is a "good chance" cases will surge again this winter.
However, flu is "unpredictable" and although Covid cases are likely to peak in December, in the worst-case scenario, flu could still pose a "significant threat" with an "intense peak" towards the end of December through to January.
Previously, the Health Minister Robert Jenrick had announced the government would invest £500 million to boost the adult social care workforce. However, Labour protests, "sticking plasters won't do".
Shadow Health Secretary Wes Streeting said the NHS no longer had the necessary staff to treat patients on time. He believes nothing in the new plans addresses a basic lack of doctors and nurses.
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