Winter. It comes around once every year. We know it’s coming, and we are usually already thinking about winters to come long before we’ve even prepped this year’s Christmas Day sprouts.
Why, then, does winter always appear take our health and social care system by surprise?
This year, the Government celebrated the fact that it had started planning for winter earlier than ever before (this planning taking place within the context of its Urgent and Emergency Care Recovery Plan to deliver improvements across urgent and emergency care.)
Within this year’s plan, the Government identifies several enablers of demand management that it hopes will mitigate the anticipated pressure on the National Health Service over the winter months. These include:
- increasing capacity by way introducing more hospital beds and ambulances to reduce the pressure on acute settings,
- improved hospital discharge pathways and processes through the implementation of transfer of care hubs,
- creating additional capacity in community settings by maximising digital technologies, and
- building on the successes many systems have seen through the implementation of more virtual wards.
What this plan appears to fail to recognise, however, is the wider context within with the health system is operating within. What about the impending unprecedented levels of industrial action and the long-term impact this will likely have on the system as a whole far beyond the winter?
And how strongly does the voice, strengths, and challenges of the social care sector shine through this plan?
What is the Government committed to doing beyond hospital discharge funding that will enable the social care sector to effectively manage expedited discharge pathways and deliver a safe and sustainable home-first approach?
We would argue that this year’s plan again misses key opportunity to take into account the lessons learned from previous management plans, and fails again to explicitly recognise the need to embed a whole-system, holistic approach that lays the foundations for the creation of proactive, sustainable and responsive local systems.
These are the types of system that – rather than responding reactively to increased demand on services once people become unwell – would channel resources and partnership activity effectively to address the wider determinants of health and wellbeing in proactive, creative, person-centred, and value-adding ways.
Shifting the focus from ‘health’ to ‘holistic,’ and from reactivity to proactivity would far better enable our fragile health and care system to maximise its collective resources and reduce demand and capacity pressures across health and social care sustainably for the long-term, and not just for Christmas.