unveiled today as local NHS hospitals and social services began work
in earnest for this winter.
The winter plans, announced by health minister, Lord Hunt, include:
between hospital and home. This money, for patients who no longer
need hospital care but are not quite well enough to care for
themselves at home without support will be put into pooled budgets
between health and social services and will be used to:
- provide step down care in hospitals, private nursing homes and
support at home
- reduce accident and emergency waiting times
- speed up the assessment of patients ready for transfer ensuring
that patients are either discharged or transferred to a more
appropriate level of care more quickly
- deliver a further drive on staff recruitment and retention for
- a minimum of 340 additional critical care beds to be put in place for winter 2000. This 15% increase on last September's numbers is
possible through the£150m cash boost first announced in May.
An additional£1m for dedicated winter planners who will target areas
where health and social services could work more effectively together
to support and encourage joint working and to stimulate rapid
development of intermediate care. These staff will be drawn from the
NHS, social services and the private sector.
Lord Hunt said:
'The NHS Plan puts patients at the heart of the health service.
We are determined to improve patients' experiences of the NHS and it
is important that people can get prompt access to high quality
care whatever time of year it is and whatever additional pressures
are placed on the service.
'The NHS Plan sets out to break down the old divisions between health
and social services so that patients receive a seamless service
tailored to their particular need. Today's investment will not only
speed up patients discharge from hospital and ensure continued care
but will also free up much needed hospital beds more quickly allowing
other patients in greater need of direct hospital care to be treated.
'The£150m will provide the NHS with 340 more critical care beds -
almost 100 more than first planned - plus 65 outreach teams. The
outreach teams signal a sea-change in critical care.
'In May we agreed to implement the radical reforms set out in the
report by the Expert Group on Critical Care. These are already
underway and will mean that critical care services will be flexible
enough to respond to patient's differing and changing care needs,
without the rigid demarcations which currently exist between
intensive care and high dependency beds. Patients will be treated
not just on dedicated critical care wards but will also be cared for
on acute wards with extra help from critical care outreach teams who
will help treat those patients whose conditions could potentially
'Reform of critical care services also includes making better use of
the critical care workforce, in particular the skills of nurses.
That's why we recently announced a further 91 nurse consultant posts
for the NHS bringing the total to over 200. Over a third of the posts
will be in critical care, and will be in a key position to help to
develop critical care nursing.
'In the NHS Plan we made the commitment to increase the number of
critical care beds by over 30% over the next three years - the 343
critical care beds which will be in place by next winter is a first
step to meeting that commitment.
'It is vital that in the coming months everyone involved in the
delivery of care joins forces to prepare for the winter
months. That is why the government is taking action now so that the
NHS and social services jointly prepare for winter.
'When even a small minority of patients do not get the care they
need. It matters to them and their families. The record NHS
investment and the reforms set out in the NHS Plan will ensure that
the NHS will be in the best position ever so each patient receives
the care they need when they need it this winter.'
1. Health secretary Alan Milburn announced the extra£150m funding
for critical care services in May this year. Of the£150m announced
£5m has been allocated directly for neonatal intensive care
and£2.5m will be used to establish a Critical Care Modernisation
Programme through the National Patients Access Team.
2. The allocations are ring-fenced for critical care services. The
NHS Executive will ensure that they are used either directly for
critical care or for service improvements that directly benefit
critical care, and where investment is recognised by clinicians as
essential to proper delivery of the service. Monthly monitoring will
be undertaken by the department's Winter and Emergency Services
Capacity Planning Team (WEST) and reported to Ministers. The
National Patient Access Team's Critical Care Programme will include
visits to critical care services where Regional Offices and WEST
identify that expert support is necessary.
3. Distribution of additional resources for critical care for 2000/01
4. Critical Care Reform
The expert group highlights the need for action in four areas:
A hospital-wide approach to critical care with services which extend
beyond the physical boundaries of current critical care and
high-dependency units making optimum use of available resources,
A networked service provided across NHS trusts which together serve
the local health community, minimising the need to transfer out of
their local health area.
Workforce development including the recruitment, training, and
retention of medical and nursing staff and balancing the skillmix so
that professional staff are able to delegate less-skilled and
Better information with all critical care services collecting
reliable management information and participating in outcome-focus
5. Copies of the Expert Group on Critical Care report can be obtained, free of charge, from the Department of Health, PO Box 777, London SE1 6XH or on the DoH website
6. Health Service Circular 2000/16 - Winter 2000/01 Capacity
Planning for Health and Social Care is available on the DoH website.