Why is winter such an issue, and what can we do about it?

It’s December and the middle of winter – with stories abounding of the pressure the NHS is under. Some in the health world wryly smile at talk of winter crises, and ask why a cold season seems to come as a surprise every year. Last year was certainly no exception, with hospitals declaring major incidents left right and centre, and stories of GPs feeling overwhelmed by their workload.

So why is winter such an issue, and what can we do about it? Answers to the winter problem are as easy to list as they are difficult to implement. In this newsletter we explore perspectives from different parts of the health care community, in the hope of piecing together a broader picture on winter and stimulating debate about what we could do differently.

Potential solutions include more preventative commissioning and services – both stopping people becoming unwell, and responding quickly to any issues. Primary care has a role to play and also local government acting broadly, from housing to action in communities to prevent loneliness. Doing this successfully will involve navigating public sector silos and finding money to double run services so that preventative services are given the time they need to take effect.

In blogs Clare Allcock sets out a commissioning perspective – telling us how her CCG have used some of their winter planning money to invest in primary care preventative schemes. Mike Hewitson explores how community pharmacists could better support colleagues.

Linked to action in communities we need more effective social care – which can prevent admissions to hospital, support people leaving hospital at the right time, and also of course support people living independent and full lives beyond their experience with health care.

Another tricky customer, this requires more funding for social care, effective working between health and social care, and exemplary partnerships between social care commissioners and providers. We explore the role of the voluntary sector in supporting people, with the Red Cross highlighting some of their excellent work.

Starting with managing people leaving hospital, but moving to people across the health and care system we need proactive management of people’s ‘flow’ along their health and care journey – with good joint working between services. Excellent operational management is needed, supported by good relationships between services and service leaders – our work on improvement shows how hard this is to achieve, and managers in services are in short supply in the current health service.

We also include a view from emergency services, with some of our Fellows talking about what life is like over winter at the sharp end of care.

If these solutions fail we may need to think more seriously about capacity planning – if winter exceeds health and care capacity every year, what can we do to put more in place between September and March? More services in hospital is heresy in the current world of fiscal constraints – underlining how important it is to exhaust other options for better care.

Hannah Butcher from policy here at the Foundation finishes the newsletter, asking if it’s time to change the story around winter. We hope you enjoy reading it, and it stimulates new thinking on a familiar health service problem.