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Winter pressures: care in real time

System Co-ordination Centre

Winter is a time of increased pressure for the NHS as cold weather affects people with existing health conditions and illnesses like flu and Covid-19 spread. As an integrated care system for north east London, we work throughout the year to build our resilience and plan for periods of increased demand.

Our approach is focused on keeping people well; helping people get the right treatments in the right place earlier; be seen more quickly in an emergency; and get home again promptly where they have had to be admitted.

Paul Gilluley

These challenges are complex and can only be addressed by working together. This winter we coordinated this work through a new clinically-led System Co-ordination Centre (SCC) that involves everyone, including hospitals, GPs, London Ambulance Service, community care and more. The SCC is data driven and means we can respond to pressure in real time.

I spoke with Ben Hurford, in his role as Head of Programme for the SCC in NHS North East London, and I asked him how the SCC has helped us. He said: “You can see what’s driving pressures in the system and we can challenge decisions. If we are seeing issues around ambulance handovers, discharge delays, extended waits in EDs (Emergency Departments), we can have conversations as a system to see what support can be offered.

“We have never had visibility of real-time data in this way. It’s exciting to see how we can do things differently, in a data driven way.

“It’s a testament to the operational teams within the providers and in the ICB. Everyone was given the framework and the timeframe and there has been a great deal of work required to get to the place we are in, and lots of credit goes to the providers.”

The SCC has been part of a number of efforts to help manage the heavy pressure that the winter months, and ongoing periods of strike activity, have on the local health system. Our hospital trusts in particular have made a huge amount of progress on national targets, including on ambulance handover times and seeing, and discharging, patients more quickly in emergency departments and urgent treatment centres.

This ongoing improvement across our integrated healthcare system was recognised as part of a recent NHS England progress review. The review was part of a national plan to recover urgent and emergency care, in which healthcare systems were placed into tiers 1-3 depending on the level of support required to improve, with Tier 1 requiring the most improvement. We were the only system in England to move from Tier 1 to Tier 2.

Challenges remain and we will be building on the learning and successes of our activity over the winter months into 2024 and beyond. This will include further focus on hospital flow, mental health attendances in our emergency departments and the development of virtual wards. This will be supported by continued digital and data innovations like the SCC but most importantly by working together across the system.

Paul Gilluley, Chief Medical Officer, NHS NEL

System Co-ordination Centre (SCC)