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Enhancing Winter Resilience in NHS England: The Role of Integrated Care and Digital Solutions

NHS digital solution

As the winter months approach, NHS England has outlined a comprehensive plan to bolster its winter resilient system. The plan focuses on strengthening integrated care boards (ICBs) and leveraging digital solutions to support primary care access. Among the key initiatives are efforts to maximize virtual ward capacity, streamline patient pathways, and ensure efficient data sharing. Furthermore, the guidance highlights the responsibilities of various organizations, including acute and specialist trusts, community trusts, and local authorities, in contributing to a more robust healthcare system during the challenging winter period.

Empowering Integrated Care Boards

Integrated care boards are assigned a pivotal role in the plan, with accountability for delivering virtual ward capacity and optimizing virtual ward utilization. The target is to maintain 80 percent occupancy rates in these virtual wards throughout the winter. To ensure success, ICBs are expected to establish appropriate step-up and down capacities to support heart failure, respiratory, and frailty patients. These virtual wards will accept referrals from diverse organizations, such as care homes, ambulance trusts, and community response teams, promoting seamless access to remote care for a larger patient population.

Additionally, ICBs will be responsible for driving standardization of urgent integrated care coordination, aiming to place patients in the right care setting, with the appropriate clinician or team, at the right time. This entails expanding the services listed in the Directory of Services (DoS) and promoting its full utilization, thus facilitating streamlined pathways and reducing duplication of efforts.

Harnessing Digital Solutions in Winter Planning

To manage winter pressures effectively, NHS England emphasizes the importance of adopting digital solutions across the healthcare landscape. For primary care, there is an emphasis on supporting practices in implementing cloud-based telephony and enhancing online patient journeys. This includes refining online navigation and triage processes, improving accessibility, and ensuring user-friendly online platforms to better match demands with capacity.

For acute and specialist trusts, the focus lies on improving bed productivity, patient flow, data sharing, and workforce management. The guidance encourages the implementation of flexible staff pooling mechanisms, supplementing traditional methods with digital solutions such as staff banks and ‘mutual aid’ arrangements. Furthermore, timely data sharing with care transfer hubs is essential for governance, clinical decision-making, and supporting care capacity and demand planning.

Community trusts and integrated care providers play a significant role in reducing variation in inpatient care and length of stay. The guidance advocates for data sharing to streamline pathways and reduce duplication, as well as the implementation of digital solutions to increase rehabilitation capacity and optimize therapist time.

Enhancing Data Flows and Insights

In addition to digital integration, the guidance underscores the need for improved data sharing and submission. Local authorities are called upon to enhance data flows, particularly in areas where limited insights hinder accurate demand forecasting for Better Care Fund services. A comprehensive view of pressures and support needs across the system can be achieved through sharing demand, activity, workforce, and capacity data in mental health provider pathways.


NHS England’s winter resilient system plan marks a proactive approach to handle healthcare pressures during the challenging winter period. By empowering integrated care boards and leveraging digital solutions, the health system aims to optimize virtual ward capacity, streamline patient pathways, and ensure effective data sharing. The plan aligns various organizations, including acute and specialist trusts, community trusts, and local authorities, to strengthen the healthcare infrastructure. As the nation gears up for winter, this comprehensive strategy sets the stage for a more resilient and efficient healthcare system, ensuring better patient care and outcomes.

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