Rapid response teams to help people who have fallen at home and 24/7 ‘care traffic control centres’ are among new NHS plans to prepare for winter, being set out today.

NHS chief executive Amanda Pritchard said the additional measures would build on the extensive work already underway to prepare for what will be a “very challenging winter.”

New 24/7 system control centres are expected to be created in every local area, which will manage demand and capacity across the entire country by constantly tracking beds and attendances – taking stock of all activity and performance for the first time.

These data-driven war rooms, led by teams of clinicians and experts, will enable rapid decisions to be made to any emerging challenges including where hospitals can benefit from mutual aid, or to divert ambulances to another nearby hospital with more capacity.

Local areas will also develop new hubs dedicated to serious respiratory infections, with patients receiving same day access to care out of hospital while also creating additional capacity for hospitals and ambulance services.

Respiratory infections, including covid, flu, pneumonia and acute bronchitis are expected to be one of the most significant winter pressures on the NHS, with modelling suggesting they could occupy up to half of all NHS beds this winter.

The NHS is preparing earlier and more extensively than ever before for winter – with plans already well underway to create extra bed capacity in hospitals and in the community, as well as increasing the number of call handlers working in NHS 111 and 999.

Expanding falls response services right across the country will see local teams sent to help people who have fallen in their home or in care homes, rather than unnecessary trips to hospital.

Based in local communities, the expansion could see around 55,000 ambulance trips freed up to treat other patients each year, with a quarter of all category three and four ambulance callouts in January this year relating to falls.

Extra remote support will also be provided to care providers to deal with falls and incidents in care homes themselves, as around two in five hospital admissions from care homes are currently fall-related.

In a letter to every local health service in the country, NHS chiefs also said they will roll out 24/7 access to professional mental health advice in ambulances services over winter which will enable more people to access the right support in their community.

The NHS continues to roll out the autumn booster programme at speed with over eight million eligible people receiving their top-up dose in just over six weeks. The national booking service is now open to everyone who is eligible, including anyone aged 50 and over.

NHS chief executive, Amanda Pritchard, said: “Winter comes hot on the heels of an extremely busy summer – and with the combined impact of flu, covid and record NHS staff vacancies – in many ways, we are facing more than the threat of a ‘twindemic’ this year.

“So it is right that we prepare as much as possible –the NHS is going further than it ever has before in anticipation of a busy winter, and today we have set out further plans to step up these preparations – building on our existing plans to boost capacity set out in August this year.

“Whether it be new services to support people who have fallen at home, hubs to treat respiratory infections, or system control centres helping us to navigate pressures across the entire country, every one of these initiatives will make a real impact on the ground – helping to relieve pressure on frontline staff as well as seeing patients quickly and directing them to where they can receive the best possible care.

“Vaccines remain an important part of our defence this winter – everyone who is eligible has the power to protect themselves from both flu and covid – so please do book in today if you haven’t already”.

Robert Jenrick, Minister for Health, said: “We are determined to deliver for patients and have set out our ABCD priorities to prepare for the winter months ahead – ambulances, backlogs, care, doctors and dentists – alongside Our plan for patients to ease pressure on the NHS.

“People who suffer falls at home will rightly benefit from expanded rapid response teams, and new innovative approaches will be rolled out to track bed availability and hospital capacity – helping patients access life-saving care more quickly.

“We are also investing £500 million to bolster the adult social care workforce and help free up beds this winter, ensuring ambulances can get back on the road as soon as possible”.

Matthew Taylor, chief executive of the NHS Confederation said: “This winter could be the toughest on record for the NHS, which is exactly why services are working together early on to make sure patients get the care they need, where they need it most.

“With falls leading to thousands of ambulance call-outs and admissions to A&E, it is vital that the NHS uses its limited resources to best effect as this will provide value for money to taxpayers and improve patient experience”.

The NHS has made good progress towards creating the equivalent of 7,000 beds by March, with an extra 1,200 beds created during September alone.

Case studies

Acute Respiratory Infection hubs

• In January, Sandwell Paediatric Respiratory Hub provided face-to-face assessment with onward referrals to see children with potential infectious illnesses like RSV, Covid and bronchiolitis. The hub helped reduce the number of patients sent to A&E, relieving pressure on the system and delivering cost savings.

Falls response services

• London Ambulance Service piloted a scheme where three cars, operated by the local urgent community response team, were allocated to suitable category 3&4 incidents direct from the 999 control room. It is estimated around 50-60% of the incidents responded to are falls-related, with the service providing a swift and effective response to suitable patients, helping to reduce conveyances to hospital and free up ambulances for other callouts.
• Hull Fall First is a falls pick-up and wellbeing response service, involving the local ICS, fire and rescue service, ambulance service, county council and community services provider. A team of firefighters received clinical training from healthcare experts, along with safeguarding training and safety awareness. The service has reduced the number of A&E attendances and provided a better patient experience for those who have had a fall.

Care home ambulance conveyance avoidance

• Weston-super-Mare have created a care home hub response, staffed by a GP clinical lead and advanced clinical practitioners who support local care homes to plan proactively for potential future care needs. They also respond to more urgent health care needs so residents can be treated at home quickly, often avoiding the need to use emergency services.
• In Mid and South Essex integrated care system, as part of a pilot a number of Raizer II chairs were purchased and distributed across care homes, secondary care and Urgent Care Response teams, alongside access to an interactive post falls assessment tool. This helped staff identify when it is safe to lift a resident from the floor without calling an ambulance, and saw 92 callouts avoided.