A detailed winter plan has today been published for Northern Ireland’s health and social care system.
With severe pressures expected on services, the importance of all parts of the system working together has never been more critical.
Representatives from HSC Trusts, General Practice, community pharmacy, social care and the Department today attended a joint summit on the challenges ahead.
The 2023/24 Winter Preparedness Plan details a series of investments and initiatives, including:
• Strengthening the Urgent and Emergency Care system to provide alternatives to Emergency Departments, including Urgent Care Centres/Urgent Streaming Services, Rapid Access Clinics and local Phone First services. These services operate alongside Trust Emergency Department services and existing minor injuries services.
• £3.4million in funding provided to General Medical Services (GMS) and Out of Hours Services (OOH) to support GP practices increase their capacity in light of the anticipated increase in demand over the winter.
• Northern Ireland Ambulance Service increasing the range and capacity of clinical expertise within Ambulance Emergency Control to help ensure cases are appropriately managed.
* Enhanced hospital capacity - for example, an additional 48 beds have been opened in Antrim area hospital in 2023 while 45 beds opened for last winter in the Ulster hospital will continue to be funded. The Royal Belfast Hospital for Sick Children, in recognition of ongoing service pressures, has increased its bed capacity by 5, which will help during the winter period.
• £4.3million provided to support GP practices across Northern Ireland to provide proactive support and care to those in nursing and residential care homes.
• Rolling out the Pharmacy First Pilot Service for Uncomplicated Urinary Tract Infection (UTI) in Women Aged 16-64 years. This will expand from the current pilot of 62 Community Pharmacies to the entire Pharmacy network of more than 500 Pharmacies across Northern Ireland, through an investment of £410,000. Over the winter period, it is estimated this will deliver 12,000 consultations, freeing up capacity in GP practices.
• Allocating £265,000 to a new Pharmacy First Sore Throat ‘test and treat’ service, which is being piloted this winter. This will be delivered in 40 pharmacies. It is estimated that around 8,000 consultations will be delivered this winter.
• HSC Trusts will jointly establish a Regional Control System which will have responsibility for ensuring system wide co-ordination for managing pressures.
• To make best use of available domiciliary care capacity, Trusts have been allocated recurrent funding of £697,000 to establish early review teams by October 2023. These teams will be responsible for completing reassessments of need within two to eight weeks of hospital discharge, with the aim of releasing capacity back into system if the patient’s needs have reduced following return home.
Performance targets have been detailed in the winter plan, covering ambulance handover times and simple and complex discharges. Performance against these targets will be published every two weeks on the DoH website from 30 October 2023 through to March 2024.
The Department of Health’s Permanent Secretary Peter May, who attended today’s summit, has welcomed the plan. He commented:
“Winter causes difficulties for all health services and we know that our system in Northern Ireland will face severe challenges. The measures set out today in this winter plan can undoubtedly help mitigate the pressures in NI but they cannot eradicate them.
“Addressing these challenges substantively requires long term planning and budgetary certainty. While the current environment does not provide these, we are taking the steps we can both for this winter and beyond within the severe budgetary constraints that exist.
“In the immediate future, the focus this winter has to be on all parts of the health and social care system working together.
“Even with these mitigation efforts, the system will inevitably be operating above capacity over a sustained period, leading to too many patients facing delays for care.
“Everyone in the health and care system will once again work relentlessly to prioritise and treat the sickest people quickest.
“I would appeal today to the public to support staff. They are working under conditions that are not of their making or choosing. Please assist them by being patient and kind and by using services appropriately. That includes cooperating with hospital discharge processes when you or a loved one are medically fit to leave hospital.”
The winter preparedness plan can be read here:
Locality plans for each HSC Trust area are also published today. These can be read on Trust websites.
The key targets detailed in the winter preparedness plan are:
• Ambulance handovers completed within 15 minutes of arrival at a hospital and no later than the two-hours.
• Average ambulance response times should be 10 minutes for Category 1 calls and 36 minutes for Category 2 calls.
• Simple discharges will take place within four hours of a patient being declared medically fit.
• Complex discharges will take place within 48 hours of a patient being declared medically fit.
• The number of simple discharges on any Saturday and any Sunday should be at least 80% of the average daily number of simple discharges from Monday-Friday in that week.
• The number of complex discharges on any Saturday and any Sunday should be at least 60% of the average daily number of complex discharges from Monday-Friday in that week