Winter brings with it pressures that put hospital services under enormous strain, but with the right preparation, the stress can be minimised

This article was part of the End of Life Care channel, in association with Marie Curie Cancer Care. The channel is no longer being updated.

The chancellor’s autumn statement included the announcement that there would be an additional £300m in government funding to help the NHS cope with unprecedented demand during winter.

On 5 December, Marie Curie Cancer Care held a Twitter chat on what steps are being put in place to prevent unnecessary hospital readmissions for those who are terminally ill and frail at this time. Effective community based services and partnerships with primary care were key themes that emerged.

Prepared for pressures

We began by asking what plans people had in place to ensure they were ready for winter pressures. Appropriate care plans and using services such as rapid response and supported discharge were solutions put forward by a clinical commissioning group and a leading homelessness charity. These are services that community based providers such as Marie Curie can provide, enabling people at the end of life to be swiftly discharged and moved to their place of choice, rather than remain in an acute setting.

The issue of workforce retention and supply was touched upon and considered a crucial factor in enabling people to be discharged from hospital and cared for in the community. 

‘Adding acute capacity did not help improve care during the winter period’

Another key theme that arose was the need for much stronger alignment between community based services and GP practices.

The NHS Confederation shared a case study from north west London, where it was found that simply adding acute capacity did not help improve care during the winter period. Instead, the focus has been moved to ommunity services, working in partnership with GP practices.

Funding and costs were also discussed. There is evidence from the Nuffield Trust that end of life nursing care provided in the community can bring about cost savings.

NHS Continuing Healthcare also helps ensure people receive the right care at the end of life through its fast track pathway. There are examples of where this works well, although data is limited.

Managing spikes

Unsurprisingly, a one hour Twitter chat was not sufficient to explore all options on effectively dealing with the pressures of unnecessary hospital readmissions during winter.

However, better forward planning and stronger collaboration between community and primary care services could ensure that, in future, the NHS is more able to effectively manage spikes in demand during winter. 

More information

Phil McCarvill is head of policy and public affairs at Marie Curie Cancer Care