Prevention of as much ill health as possible is key. People with chronic respiratory disease must have planned reviews for treatment optimisation and exacerbation plans before winter. Flu and COVID-19 vaccinations are essential for these and other patients with long term conditions, so all clinical teams must enable their delivery. Appropriate specialist follow up after admission in these and many conditions can prevent readmission.
2023/24 winter planning
Urgent and emergency care
We're sharing resources based on the four evidence based interventions recommended by the RCP.
The Royal College of Physicians (RCP), Society for Acute Medicine (SAM), British Thoracic Society (BTS) and British Geriatrics Society (BGS) have responded to NHS England’s national approach to 2023/24 winter planning.
We believe hospitals can maximise the impact of the current workforce by making four evidence based interventions.
We recommend early screening for frailty of admissions for people over 65 with Clinical Frailty Scale and 4AT (for delirium). This identifies people who need rapid frailty assessment by specialist multi-professional teams. Front door frailty care must be a priority for these clinicians.
The staffing of acute admission units and SDEC units should enable people to be treated without admission where possible. Patients requiring short lengths of stay (48-72 hours) should receive optimal care. Patients requiring longer hospital stays must be cared for by the appropriate multidisciplinary clinical teams. Current ‘temporary beds’ or ‘outliers’ should be converted into multidisciplinary medical wards.
A greater focus on coordinating discharge is vital. This is already being done well in around a third of hospitals and must be replicated across the system. It requires close collaboration between ward teams and care coordination teams. Discharge to Assess, and early supported discharge - particularly for patients with COPD and heart failure - must be maximised. Hospital at home teams should be focused on these pathways.
Acute respiratory infection hubs
An integrated care approach with the potential to improve patient outcomes and address service pressures.
Early screening resources
RCP and GIRFT frailty care
A series focusing on the challenge posed by increasing demand for frailty care from an ageing population in England. GIRFT is a clinically-led programme helping to improve the quality of care within the NHS using benchmarking data to support best practice and reduce variation.
Other early screening resources
Demand and capacity
Get help with your demand and capacity planning.
- Why is Demand and Capacity important? A clinical and operational perspective
- Demand and capacity emergency department model
Resources exploring the delivery of SDEC in ambulatory emergency care (AEC) units.