Health and care organisations across north east London are working together to ensure NHS and community-based services are ready to meet growing demand this winter.
Quicker ambulance handovers, expansion of same-day emergency care at local hospitals and greater use of virtual wards are all set to benefit patients in the months ahead.
Winter is always a busy time for health and care services as seasonal illnesses such as flu and Covid-19 begin to spread and colder weather takes its toll on those with existing conditions.
To help meet demand, local partners have been working closely to build resilience by planning for periods of increased pressure on services and expanding support for those most at risk.
As part of this, a clinically-led System Coordination Centre (SCC) – involving local hospitals, GPs, London Ambulance Service, community care providers and other organisations – has been established to strengthen collaboration and data sharing across north east London.
Using real-time data, the SCC gives staff vital oversight of how busy services are in north east London at any given time – enabling them to proactively support patient flow in local hospitals, smooth discharge processes for those returning home after treatment, and reduce avoidable hospital admissions by diverting to other appropriate services. A key priority is ensuring people can access the care they need closer to home, so the NHS is working with local authorities, the voluntary sector and community organisations on a range of initiative across Barking and Dagenham, City of London, Hackney, Havering, Newham, Redbridge, Tower Hamlets and Waltham Forest. These include:
Virtual wards – Thousands of people in north east London (NEL) are receiving NHS treatment at home rather than in hospital, thanks to the expansion of virtual wards. Also known as ‘hospital at home’, virtual wards allow patients to receive care safely and conveniently within their own homes. This means some are spared a stay in hospital while others can return home sooner after inpatient treatment. Since October 2022, more than 11,600 patients have been admitted to virtual wards in NEL and there are currently 470 ‘virtual beds’ available with plans to expand this. For every patient admitted to a virtual ward, a bed is freed up at local hospital.
Same day emergency care (SDEC) – Barts Health NHS Trust, which runs Royal London, Newham, Whipps Cross hospitals, is looking to continue its expansion of its SDEC services over the winter period. These services provide faster treatment within dedicated units for those patients who would otherwise be admitted to a ward, allowing emergency departments to focus on the most complex cases. Last winter, about 3,500 patients per month benefitted from an SDEC service, and Barts is looking to increase this to 4,500 per month this winter.
Reduced ambulance handover times – Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) is working closely with London Ambulance Service to ensure patients arriving at King George Hospital are transferred from ambulance crews to A&E teams within 45 minutes. This has reduced the average handover time to 23 minutes and increased the number of handovers completed within 15 minutes from 18% in April this year to 34% in September. This collaborative work, which was recognised with an NHS Parliamentary Award in October, reduces delays for patients and gets ambulance crews back on the road faster.
- Ensuring medically fit patients can return home quicker – Working closely with local partners, BHRUT has been running week-long exercises at Queen’s Hospital which aim to tackle delays for patients who are ready to go home. This has included creating dashboards for each ward – with detailed information on length of stay, daily discharges and additional winter demand. This helps nursing staff understand the number of discharges which need to happen every day during winter to reduce delays for A&E patients getting to a ward, and for medically fit patients to have the right care and support in place before leaving hospital.
- A falls improvement scheme is in under way in Redbridge. This includes using GP systems to identify those at greatest risk and ensuring community-based staff work with a social prescriber to ensure at-home support is put in place to prevent slips, trips and falls. Extra local support is provided by Age Concern, a pharmacist, a physio, an orthopaedics specialist or other services, as required. This aims to improve people’s quality of life and prevent a potential hospital admission.
- Winter vaccinations – Covid-19 and flu vaccines are being offered to all those in eligible groups and, for the first time this winter, a new vaccine is being given to pregnant women and older adults to protect newborn babies and people aged 75-79 against Respiratory Syncytial Virus (RSV). The protection vaccines provide is the most effective defence against serious illness or hospitalisation this winter.
- Routine GP appointments out of hours: People across north east London can now access routine appointments and health checks in the evenings and weekends. Appointments are available in advance and on the day, with face-to-face and remote consultations available. Urgent GP appointments are also available on all weekday evenings and at weekends, and these can be booked via a patient’s surgery during opening hours, an urgent treatment centre or via NHS 111 at other times.
Dr Paul Gilluley, Chief Medical Officer for North East London, said:
“We all know that winter brings extra pressures for our health and care services so our approach is focused on keeping people well, improving access to treatment for those who need it and ensuring patients can return home promptly where they’ve had to be admitted.
“We are doing this in a number of ways, including by increasing efficiency within our hospitals to improve patient flow and working to reduce avoidable admissions with extra GP appointments and initiatives to support people at home or in the community.
“The challenges are complex and can only be addressed by working together so, building on the excellent progress we made last winter, we are continuing to coordinate our plans with our local authority and voluntary sector partners. It’s been a huge collaborative effort.” For more information on the best route to urgent care this winter, including what to do if your child is unwell, go online and visit www.northeastlondon.icb.nhs.uk/urgentcare.
