A working group to look at ways of tackling winter pressures in Scotland has held its first meeting amid warnings of continuing pressure on 'fragmented' services.

The group was set up earlier this year after Scottish health minister Susan Deacon bowed to pressure from the royal medical colleges to set up a group to help prevent a repeat of last winter's problems.

The 18-strong group is chaired by Neil Campbell, chair of Dumfries and Galloway health board. It is due to have four meetings before presenting a report to Ms Deacon by the end of July.

Ms Deacon now admits that the NHS faced 'unprecedented demands' last winter and coped largely because of the 'sheer dedication and hard work of staff '.

She recently announced an additional£60m for health boards and part of this cash will be used to help with winter planning.

Dr Charles Swainson, medical director of Lothian University Hospitals trust, which has borne the brunt of the criticism for perceived failures over the past two winters, said the group needed to address 'unprecedented demand'.

'Last year and the year before that we have seen an increase of between 30 and 50 per cent in patient numbers on certain peak days. We don't know when these peak days will occur but it coincides with poor weather.'

He added: 'The numbers of elderly continue to rise in this area and we need to have more effective planning for the winter as we predict a similar rise in numbers for this year.'

Better communication between social work departments and the health service is being seen as the key to reducing bed blocking and getting elderly patients seen and back home as quickly as possible.

Margaret Pullin, acting secretary of the Royal College of Nursing in Scotland, said the solution was to plan for 'the worst-case scenario'.

She also suggested a shift of effort was needed: 'If the community were better resourced, then a lot fewer people would need to go to hospital.

'The whole system is so fragmented and there is a reluctance, which admittedly is reducing, for GPs and trusts to accept advice from the centre about how the whole service should operate.

Welsh health secretary Jane Hutt has announced a cash injection of£35m for the NHS.

The money is for joint working between the health service, social services and other groups to reduce winter pressures and waiting lists.