A sustainable funding model and planning for the whole year, not just winter, is required to ease the NHS’s seasonal pressures

In the autumn, the media threw their seasonal spotlight on emergency departments, and the government provided £400m winter pressures funding.

Services did not fall over under the strain and performance against the four-hour target remained stable. However, figures from NHS England show that the number of patients admitted reached a 10 year high. The proportion of people who attend A&E who end up being admitted has also increased over the past decade from 21 per cent to 27 per cent.

‘It is likely that the rise in admissions also reflects an increase in patients with more complex conditions’

The rise could indicate that trusts spent their winter money on more staff and beds. But HSJ analysis of 49 CCG areas suggests a more complex picture: a third did not invest in extra clinical staff and over half had not increased beds.

Significant proportions invested at least some of their funds in discharge teams and increasing mental health staffing and out of hours primary and community care.

It is likely that the rise in admissions also reflects an increase in patients with more complex conditions. The trend will continue and accelerate, so it will be necessary to step up investment in preventive measures, as well as increasing links with ever stretched social care teams.

This will require sustainable funding much earlier in the cycle and year-round planning to ensure that the right services are in place.

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