A letter sent to integrated care boards (ICBs) on Friday set out plans to increase 'capacity and operational resilience' in urgent and emergency care ahead of winter.
An accompanying assurance framework seen by GPonline says the additional 1,000 social prescribing link workers and health and wellbeing coaches would work with patients who are 'stepping down from high intensity user services' and who had 'non-medical needs where social and lifestyle issues are a significant risk factor'.
The 1,000 new care coordinators will be focused on developing personal care plans for patients with multiple long-term conditions who are at high-risk of hospital admission, the document said.
It is unclear whether further money will be made available to primary care networks via the additional roles reimbursement scheme (ARRS) to fund the recruitment of these new roles.
NHS winter plan
As part of the winter plan ICBs will also be expected to support practices by 'rapidly prioritising' interventions that improve patient access and tackle staff workload, the document said. As part of this boards have been told to engage in national processes 'to secure potential funding for technology/estates solutions'.
ICBs have also been told to set up dedicated primary care teams to 'engage with and support' practices and community pharmacies and help them to prepare for winter pressures. The assurance framework says that ICBs should provide 'intensive hands-on quality improvement support' to practices in the most challenging circumstances, which includes those in areas of high deprivation or facing workforce shortages.
NHS England also intends to 'scale up' the use of virtual wards to help better support people at home, with plans for an additional 2,500 'virtual beds' to be created this winter.
The framework also advised ICBs to:
- Work with PCNs and other providers to set up collaborative models to manage 'specific winter pressures', such as pulse oximetry monitoring for COVID-19 and 'winter hubs'.
- Expand the number of practices using cloud-based telephony systems.
- Expand the availability of business intelligence tools to practices to help them 'understand demand and capacity' and also provide support for practices so they can use these tool to improve services.
- Ensure patients are directed to the right services and communicate clearly on primary care pathways and processes.
NHS England's letter said it was 'essential that ambulance and NHS 111 services have the necessary capacity in place and that access to primary care, community health services and mental health services for urgent patients is sufficient to ensure patients do not need to present to emergency services'.
Impact of COVID-19
Meanwhile the letter said that new variants of COVID-19 and higher levels of flu in circulation this winter 'suggest that even in optimistic scenarios, high numbers of beds may be needed for respiratory patients during winter'.
NHS England's national medical director Professor Sir Stephen Powis said: 'Winter is always a busy period for the NHS, and this is the first winter where we are likely to see combined pressures from COVID and flu, so it is right that we prepare as early as we can for the additional demand that we know we will face.
'Ahead of the winter, we want to make sure we are doing everything we possibly can to free up capacity so that staff can ensure patients get the care they need – this includes timely discharge, working with social care, and better support in the community with the expansion of virtual wards.'
BMA chair Professor Philip Banfield said the plan was 'a step in the right direction' however he added that it 'lacked detail and is missing many of the most fundamental measures that doctors know are needed to drive down waiting times and improve patient safety'.
He said: 'Adding more hospital beds is crucial to increasing capacity, for example, but this promise is meaningless without the staff to treat patients in them. Likewise, suggesting working more closely with social care means nothing while there are more than a million staff vacancies across that sector alone. Staffing gaps in both health and social care must be properly addressed if anything is ever going to change.
'It is encouraging that this plan promises to recruit more call centre staff and, in general practice, social prescribing link workers and health and wellbeing coaches, but that is just not enough. We need more GPs and funding of staff to support them as primary care bears the brunt of hospital backlogs and patients that can’t access the care they need.'