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A package of measures to deal with this years winter pressures was ...
A package of measures to deal with this years winter pressures was

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:

£63m cash boost for step down care this winter to bridge the gap

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

the winter

- 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,

including beds.

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

non-clinical tasks.

Better information with all critical care services collecting

reliable management information and participating in outcome-focus

clinical audit.

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.

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