Reducing winter pressures on the NHS

As the days get shorter and colder weather sinks in, the media has been awash with its usual smear of headlines questioning how the NHS will cope this upcoming winter. The NHS experiences winter pressures every year, as the rise in the number of people admitted to hospital leaves services at breaking point. However, despite planning for this spike in attendance, it remains ever difficult to manage the challenges that are faced and meet the growing patient demand.

This year, additional fears of a looming crisis have been raised after figures were published by Monitor and the NHS Trust Development Authority outlining the financial positions of the NHS for the first 3 months of the 2015–16 financial year. They reported a combined deficit of £930 million for the 151 Foundation Trusts and 90 other NHS Trusts in England, which is more than the entire full-year deficit for 2014–15 of £829 million. As part of these figures, ambulance services in England have run up a £6 million deficit (Monitor, 2015; NHS Trust Development Authority, 2015).

If the NHS is going to avert a crisis this winter, a whole systems approach is needed ensuring coordination across all services to create a manageable flow of patients in and out of hospitals. This year, a number of initiatives have been introduced in the hope that some of this pressure can be alleviated.

The NHS has sought the help of the fire service in a new health partnership aimed at tackling health and social problems and reducing winter pressures. NHS England, Public Health England, the Fire and Rescue Service, Age UK and the Local Government Association have signed a consensus agreeing to work together to prevent or minimise service demand, and improve the quality of life of people suffering from long-term conditions (NHS England, 2015). The fire service currently carries out 670 000 home safety checks each year, assessing the homes of the vulnerable and offering advice on how to make them safer. The consensus will enable firefighters across the country to carry out more ‘safe and well’ checks in people’s homes when they visit. As well as reducing the risks of a fire, the ‘safe and well’ checks will aim to reduce health risks such as falls, loneliness and isolation and therefore reduce visits to A&E, broken hips and depression. Additionally, the NHS’ largest flu vaccination programme has been launched as part of their ‘Stay Well This Winter’ campaign (Association of Ambulance Chief Executives, 2015). For the first time, all of the youngest primary school children will be eligible to receive the free nasal spray vaccine. As in previous years, the adult flu vaccine will be offered for free to those in groups at particular risk of infection and complications from flu.

There needs to be closer cooperation between medical and social care services and attention to wider public health issues if the NHS is to stand any chance of making it through the winter intact. It is hoped that the initiatives highlighted will go some way to making this a possibility.


Association of Ambulance Chief Executives (2015) Launch of the largest flu vaccination programme marks the start of NHS “Stay Well This Winter” Campaign. (accessed 2 November 2015)

Monitor (2015) NHS foundation trusts: quarterly performance report (quarter 1, 2015/16). (accessed 9 October 20150

NHS England (2015) NHS and Fire Service sign new consensus to help vulnerable and reduce winter pressures. (accessed 1 November 2015)

NHS Trust Development Authority (2015) NHS Trusts—Financial Position for Q1 of 2015/16. (accessed 9 October 2015)

Taken from Journal of Paramedic Practice, published 6 November 2015.

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