'A difficult winter ahead' as NHS Trust announce Covid-19 emergency plan 

 COVID recovery and winter 2021/22 emergency plan.

The North West Anglia NHS Foundation Trust (NWAFT) have announced its’ COVID recovery and winter 2021/22 emergency plan. - Credit: Hinchingbrooke Hospital

The North West Anglia NHS Foundation Trust (NWAFT) which oversees  Hinchingbrooke Hospital, Peterborough City Hospital, Stamford and Rutland Hospital have said it is going to be a "difficult winter".  

Phil Walmsley the (NWAFT) CEO spoke at a meeting November 9, of Peterborough City Council Adults and Health Scrutiny Committee held at Sand Martin House, where the COVID recovery and winter 2021/22 emergency plan was announced. 

Phil Walmsley, NWAFT CEO said: “We are going to have a difficult winter. 

“The NWAFT winter plan will form part of a wider system plan with input from all provider partners that will be submitted to NHS England. 

“The Trusts plan was presented to the NWAFT Board in a draft format in September 2021 and was sent to NHS England at the end of October 2021. 

“It is important to note that this will remain a live document, to adapt to changing pressures across the winter addressing issues across all patient pathways such as emergency, elective, women and children’s, diagnostics and outpatients. 

“The plan contains the current understanding of what the issues that there will be across winter, and the proposed actions to address these issues"

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“It is important to note that the Trust winter plan has a number of systemwide dependencies, and so therefore, the Trust works with its partners across health and social care. 

“We have had a outside body assess our current way of working and they have concluded that if we continue to work in the way that we are, we shall have a deficit over the 2021/22 winter period of some 70-90 beds. 

“While this represents quite considerable pressure, it is not that dissimilar to the pressure under which we are currently working, and we have a substantial number of patients being cared for in our emergency department overnight which is inappropriate. 

“The conclusion of the Trust is that we are going to have a difficult winter – it would be foolish of me to sit here and say that we won’t. 

“There are a number of key-issues that will cause that: we’ve seen a very prolonged pandemic, which has exhausted our staff. We have a cohort of staff who are now very tired, they have worked tirelessly and with real commitment and passion; but there is a point at which even they start to run out of energy, and we saw this ‘kicking-in’ two or three months ago. 

“This has been compounded by the fact that we are struggling to recruit staff – its not just us, of course in the NHS, but the health care sector as a whole which impacts across the entire patient pathway. 

“We are expecting to see a surge in respiratory infections – the masks that we’ve all been wearing have been absolutely fantastic, but one of the things that is becoming evident is that people have not built up their normal resistance to respiratory syncytial virus which affects children, or the flu. 

“We are therefore expecting and have planned for a surge in RSV in children, flu in the general populace as well as a winter surge expected in COVID. 

“All of which puts yet more pressure on us as an organisation.” 

Cllr Dr Shabina Qayyum, who is an NHS GP herself, asked: “Over the course of the last few weeks where we have seen an increase in discharge patients, a lot of them are turning out to be failed discharge patients – do you have any data on how many of them have had to be re-admitted from failed discharges?” 

Mr Walmsley responded: “On the failed discharge and re-admitted numbers they are normally around the complex patients, and we are seeing about thirty of these per day. 

“But this only represents something like 1-2% of all our patients that we see, and most of those are either about us failing to prepare early enough for that patients’ discharge – and that is one of the areas in the 2021/22 winter plan that we hope to improve – but it is equally that we often don’t co-ordinate well with our community colleagues so that when the patient gets home the level of care received is not enough, or their ability to cope on discharge is not enough – so we do see a number of the patients coming back in, probably about 10-20% of those discharged that do come back. 

“In most cases we can manage them at their home, but it does require a lot of extra resource.” 

Cllr Dr Qayyum came back, asking: “What is it that you are doing specifically to address this problem this year, as we see the same problem year-on-year, particularly this year with all the additional pressures of COVID?” 

Mr Walmsley replied: “What we are doing and can do is to try to increase our wellbeing offer to staff and provide additional support to our partners who are working with patients from home. 

“As you know only too well, Dr Qayyum, we’ve had enormous difficulties in recruiting staff and that coupled with a tired workforce has not helped. 

“We all know that there’s been a reduction in the health education budget over the last ten years, and I believe that the problems we’re experiencing now are as a direct result of that reduction in spending to provide UK-trained doctors and nurses available. 

“The NHS has been relying on additional doctors, nurses and care staff coming over from various countries in Europe, but that supply too has now been cut-off, and just to make things worse through COVID there has been a very strong moratorium on international travel, so our ability to recruit overseas had also been reduced giving us a ‘triple-whammy’. 

“What worries me the most is our inability to get health-care assistants to support our partner services and that’s the first time in forty years that I’ve seen that happening. 

“However, we will, as part of the 2021/22 winter plan, be providing an additional £1.5m to spend over the winter period, and a further £2m for elective work which will go alongside the £12m that Cambridgeshire and Peterborough have put into the system already. 

“We also want to reduce ambulance handover delays and thereby reduce patient time in the Emergency Department.” 

Members of the Adults and Health Scrutiny Committee noted the approach NWAFT will be taking to prepare for winter 2021/22 to support emergency and elective activity.