Winter crisis fears prompt NHS to set up new national ‘surge’ contract to free up hospital beds

Fears of a winter crisis in the NHS have prompted health bosses to set up a new national service to provide urgent help to hospitals if they become overwhelmed.

NHS England is advertising for a £35m contract for the first-of-its-kind service that will be activated when any hospital in England starts to run out of beds for patients.

It comes as Boris Johnson is set to unveil the government’s winter plan for managing coronavirus in the coming months as cases rise and the number of patients in hospitals reaches more than 8,000. Ministers have already ruled out the use of vaccine passports and another lockdown but may bring back rules such as the mandatory wearing of face masks and working from home.

The new NHS service will be designed to get low-risk patients discharged back home and provide them with community based “wrap-around care”. This will help release hospital beds for sicker patients and relieve pressure on A&E departments and mean beds are available for patients needing routine treatment.

But experts have warned the new service may struggle to work at a local level, while hospital leaders warned the mere fact the NHS is having to set up such a facility is proof that the health service does not have enough capacity to meet demand.

The prime minister has announced an extra £5.4bn for the NHS for the next six months to help it cope with pressures over winter, including £478m to continue discharging patients home earlier, with six weeks’ funded care.

NHS England advertised the contract at the end of last month and aims to have a service in place by October.

It said it was looking for either a single provider, or a consortium of organisations to deliver what it called “a seasonal surge support offer that will be made available across England”.

The concept is being modelled on the response to Covid-19 during the past 18 months with more than 182 services across England helping to get patients discharged home from local hospitals.

With A&E departments reporting their busiest months ever in June and July, there is a fear among health bosses that this winter could be the worst ever for the NHS, with thousands of Covid patients still in hospital and more than 20 per cent of England ICU beds taken up with coronavirus patients.

A surge in flu cases could hit the NHS particularly hard at a time when it has no extra capacity.

NHS England said: “For the past few winter periods, health and care systems have seen increasing amounts of pressure, particularly in urgent and emergency care. For the past three winters NHS England has funded national providers on a reactive basis to commission crisis surge support to relieve pressure in the most challenged areas of the system.

“Recognising that pressures fluctuate and are not solely contained to winter there is a need to look at a more sustainable, longer term approach to surge support.”

The new service will aim to get patients who are classed as medically fit to be taken home and be provided with community care that helps prevent them being readmitted.

NHS England said the new service would be primarily aimed at helping local areas between October and March but could be extended.

Helen Buckingham, director of strategy and operations for the Nuffield Trust think tank, said: “It is positive to see that NHS England have recognised the need to plan for peaks of activity that can happen at any time of year.

“However, given the emphasis on developing relationships and services in local areas I am surprised to see a proposal for a national service being commissioned rather than encouraging local leaders to plan for this type of service, building on their experiences of working with the voluntary sector and offering mutual aid during the Covid peak.

“It is very difficult to see how such a service could work in practice across a wide geographical area when local knowledge and local relationships are so important.”

NHS Providers, which represents hospital trusts who are likely to call on the new service, warned they could face “significant pressure” this winter due to Covid-19, flu and general pressures of the colder months, as well as workforce shortages of 90,000.

Chief executive of NHS Providers, Chris Hopson, said it made sense to try and find a way to maximise capacity and voluntary services and private hospitals had played a key role in helping the NHS during the Covid crisis.

But he added: “Trusts will obviously want to ensure that any nationally procured service in this space complements and dovetails with core local NHS provision and that any funding used on the service provides good value for money and doesn’t create an additional burden on trust resources.

“However, the fact that NHS England has to explore procuring this service in the first place points to a fundamental issue – that the NHS currently has insufficient capacity to meet its current challenges. The forthcoming spending review is the ideal opportunity to address this problem.”

NHS England was approached for comment.