Winter Pressures NHS

People are the ultimate cause of the NHS winter pressures, but it would be unfair to blame the public for the random and inconsistent nature of illness – especially during the colder months that contribute to becoming unwell.

The cold weather makes people ill indirectly. The body expends more effort and energy on staying warm against the elements and thus loses some of its vigour and potency to be active and motivated. Behind the scenes this also impacts the body’s ability to fight off all manner of bugs, viruses and infections.

Cold weather also sees an uptick in the amount of people using public transport rather than walking, or being indoors socially rather than in fresh air. One thing leads to another (the coughs and runny noses) and et voila – colds, the flu, and Covid are all knocking people around for months.

We already mentioned above the issues with these ailments and injuries, but mental health problems like Seasonal Affective Disorder (SAD) are notoriously problematic during the darker months. A lack of Vitamin D and sunlight has a big impact on some people, but also the isolation and limitations of the darker hours, the lack of public safety… these restrictions can cause people’s mental state to deteriorate too.

Chronic or long-term conditions are also exacerbated by the cold, requiring more attention and intervention. In some cases this becomes too much for care at home and requires hospital admission – adding to the national bed shortage. This isn’t to blame the care sector; they have many of the same issues as healthcare re: budget, staff availability, staff retention, and their capacity to provide care. Carers are not nurses or doctors. They have limits, and services like the NHS are there to take over when things get problematic.

On the issue of staffing: Staff get ill, their family members (especially children) and friends get ill. If a clinician is ill, they can’t work and deal with the surge in demand. This doubles the problem – for healthcare and care provision.

The final problem is energy, which is a financial burden. Energy costs go up in the winter because it’s colder and people need to stay warm so their bodies can focus on healing and their minds can be as stress-free as possible to accelerate this process and ensure the best possible outcome. It’s also darker for longer, and people need to be able to see – staff to work, to treat, to operate, and patients to eat, drink, use the bathroom, be mobile where necessary. This cost cannot be avoided, but with the pandemic, the war in Ukraine, and Brexit, the United Kingdom has experienced many a sharp rise in the cost of energy. Electricity but especially gas have both jolted upwards in price, and healthcare providers can’t avoid paying. Instead, savings must be made from elsewhere – savings that impact care provision.

The final winter pressure is that the incumbent Labour government has had the winter fuel allowance scrapped – or rather, made winter fuel allowance changes for most of those people eligible.

Do all pensioners get winter fuel allowance?

No. If you were born before 23rd September, 1958 then you can be considered, but the new rules as set out by Chancellor Rachel Reeves is to reduce the winter fuel allowance eligibility to just those on pension credits or in receipt of other means-tested benefits. 

How much is winter fuel allowance?

Pensioners are eligible for £200 to £300, according to the UK government’s webpage on the Winter Fuel Payment. This is for the winter period overall.

When is winter fuel allowance paid?

Dates vary, but eligible people are contacted directly by the government to inform them of the sum they will receive and a payment date.

The winter fuel allowance is a benefit, and reduced eligibility can certainly be considered a winter pressure because to cut it is to inevitably cause some form of deterioration of health in elderly people.

Ofgem, the energy regulator, has raised its energy price cap by 10%. This isn’t sustainable for the poorest and most vulnerable in society – of which the elderly make up a sizeable portion.

Cap rises have been part-and-parcel of UK life since the pandemic. April 2022 saw a £700 increase in the cap to £1,971, which then jumped to £3,529 by October 2022 and £4,279 by January 2023. The energy cap has, thankfully, fallen since then, but not back to the £1,100 range we were used to being in and around. July 2024 was at £1,568 and now in October it has jumped to £1,717.

The government is right to address wastage or inefficiencies in the provision of services and support, and they are reportedly saving £1.4 billion in the process – no small sum – but there is a risk of being judged as careless or even unethical, given that there are approximately 10 million pensioners who will now do without.

The Telegraph states the NHS will incur additional costs of £169 million, which mathematically seems worthwhile, but the human impact is that people will then be forced away from the comfort of their own homes to use NHS services. The hope is that the government will use the savings to support its ambitions for greater community care services and more GP services, but that is a wait-and-see case for the parliamentary term ahead.

We know what the pressures are now, but how does that translate for healthcare?

• Waiting Lists: More demand means a greater wait for an appointment and potential treatment.
  
  
• Bed Shortages: More demand for hospital services, and an overspill from the care sector, puts increasing pressure on the availability of hospital beds.
  
  
• GP services: The UK’s shortage of GPs is impacting the rate at which patients can be seen by their local surgery, which can lead to patient deterioration and hospital admission.
  
  
• Inappropriate use of A&E: Some patients unable to be seen quickly by a GP will be impatient and use Accident and Emergency as an alternative for clinical assessment.
  
  
• System Inefficiency: Outdated or basic healthcare technology cannot provide the efficiencies to the care process or the insights to help optimise care treatment, which can result in delays or repeat visits.
  
  
• Financial Management: The cost of living crisis and subsequent increases to utility, food, and overall prices means more expense for the NHS and other providers and the need to make savings from somewhere to ensure that staff can be retained, services provided, and facilities functioning.
  
  
• Staff Retention: The cost of living crisis, and missed pay improvements during the course of the last government’s tenure, have left healthcare professionals in dire need of pay restoration. Health and care providers need to find more money to ensure staff don’t quit their roles and contribute to further burden on colleagues or an increased waiting list for support. None of this is an individual’s fault – people are entitled to change roles and ask for fair pay – but patients can and will suffer, so the provider must find a solution.

Solutions are what The Access Group does best, so we’re going to show you the benefits of technology in healthcare from software such as our own.

As explained in our other article on summer and winter pressures, good healthcare technology – whether ours or rival solutions – can help healthcare providers with better future planning, faster discharge to avoid delays and congestion, improve independence through patient engagement, and ultimately improve mental health and wellbeing by avoiding the stress of uncertainty and suffering.

So, what can we do to alleviate that?

Rio EPR – electronic patient records:

This is our chief solution and our biggest seller. Access Rio Electronic Patient Records does what it says on the tin – it’s an electronic record of patient medical information and other clinical notes, but it has the capacity through additional modules to expand into care, mental health support, and many other facets of life and wellbeing.

Our solution is also interoperable, meaning we can connect it through APIs to work with existing hospital systems and competitor software.

Our aim is simple: we want to improve healthcare outcomes. We want people to be well and stay healthy. With Rio EPR or Rio Cloud, we can deliver a centralised patient record that is highly accurate, quick to access, and that speeds up the notetaking process for clinical staff so that patient care is the priority, not administration.

Access Patient Flow Manager:

Access Patient Flow Manager – or APFM for short – is all about efficiencies within hospital and the care pathways that patients undertake.

Our solution provides:

• Full visibility of patient pathways, to avoid incorrect direction for care/treatment.
• Reduces waiting times by speeding up care decisions and thus freeing up beds.
• Integration, so that clinicians can stick to one sign in and one entry of notes into a joined-up care system. Everyone necessary gets the information without repeat input.
• Reduces risk and improves patient safety through these more accurate notes. One picture of a patient’s needs, improved outcomes through better decision making.
• Real-time access to information. No delays, no waiting on slow computer systems.

All of the above improves the notoriously slow process of handover notes too. Better information with easier access means easier communication. We design our record solutions to work at-a-glance, as well as in detail.

Based on testimony from the Berkshire Foundation Trust (April 2020 – March 2021), Access Patient Flow Manager helped reduce handover meetings from 22 minutes on average down to as little as five minutes in some cases. Most importantly we helped achieve a staggering 83% increase in the intended or expected discharge rate. That means people were moving through the system quicker while still getting the same high calibre of care and thus more people could be seen. That is a huge win for all involved.

Access EarlyPay:

The NHS spends a lot of money on paying for agency staff to combat staff shortages. Due to the urgency involved in their recruitment, they are paid at a notably higher rate than bank staff within the NHS trust or health board.

Integrated Care Boards are working on ways to be able to share and swap clinical staff so as to get the most amount of care delivered, but another way to help is via Access EarlyPay. Our solution allows staff to be paid straight after doing overtime – rather than with a significant delay.

Hansard, the Parliamentary record, reports an exchange on NHS staff food banks from the House of Lords in 2023. In it, Baroness Merron states: “a survey by the Cavell Nurses’ Trust found that 14% of nurses and health workers are using food banks to feed themselves and their families, and nearly 70% are either unprepared or very unprepared for a financial emergency.”

Access EarlyPay can give quick turnaround on earnings for overtime in a way that the NHS currently cannot; saving the local NHS trust money whilst also ensuring staff retention.

Access Elemental Social Prescribing:

Social Prescribing is a care concept that community-based preventative action such as social activities, exercise groups, and getting outdoors more will help mitigate less acute physical and mental health issues.

Access Elemental Social Prescribing is a cloud-based, digital social prescribing platform. It is designed to connect GPs, NHS trusts, and social prescribing link workers (amongst others) so that users can make, manage, and report on referrals to social prescribing, care coordination, health coaching and general wellbeing, safely and securely. There’s additional functionality for reporting and data analytics too.

The purpose of Elemental is to help you manage, scale, and measure the impact of the social prescription programme created by you (your Social Prescription Programme). In order to do this, you (or others included in your programme) will need to give us details about the various staff members, health and social care workers, housing staff, community providers and patients who you would like to be involved in your programme. Some of this information will include Personal Data (that is information which can be used to identify an individual).

Access Elemental Social Prescribing has four modules:

• Marketplace: Ready-made Directory of Services
• Case Management System: For health, wellbeing, & social prescribing teams
• Connector Plus: A third party integration engine
• Analytics: Business intelligence dashboards, informing data-driven decision making

We’re extremely proud of our solution. It currently serves a population of over 20 million people, boasts two-way integration with EMIS, SystmOne & Vision, as well as being THE only social prescribing/wellbeing platform integrated with mental health EPR (Access Rio) & social care system (Access Mosaic).

We have designed this with clinicians and other health and care experts so it can provide a robust suite of reports & dashboards, as well as vital access to real-time data associated with uptake. 

Between these four solutions we offer ways to tackle most of the winter pressures affecting the NHS. Access Patient Flow Manager can tackle bed shortages. Access EarlyPay can help with staff retention. Access Rio EPR can solve system inefficiencies, and Access Elemental Social Prescribing can help both GP services and the inappropriate use of A&E. The combination of these – all or not – can achieve the financial savings the NHS is so desperate for; money that will then keep the heating on, or help with facility maintenance, or help recruit additional staff to provide more care or new services. How the NHS spends their money is their business, but at Access we can help give them more freedom and flexibility to do what’s best for the patients they serve.