Board report: English systems in winter

Key points

In the South East, 2% of ambulance handovers took over an hour in January this year. However in the South West, 26% of handovers took over an hour. (NHS regions)​

In the South West, 34% of all the people who attended A&E at hospitals across Cornwall and The Isles of Scilly Integrated Care Board (ICB) area waited over 12 hours to be admitted to hospital, after a decision was to admit them. The median figure across all ICBs in England during January was just 12%.

In January, 11% of attendances at A&Es across hospitals in North Central London ICB, were people who had attended A&E in the previous 7 days. Across Shropshire Telford and Wrekin ICB, this figure was around half as many (6%).​

Some regions face challenges across multiple domains of care

What will be the impact on care outcomes for people who live there?

In the East of England NHS Region

• The number of registered nursing home beds dropped by just over 5%, between April 2022 and January 2023
• In January 2023, 19% of ambulance handovers took over an hour
• The region has some of the lowest proportion of GPs, Care Homes and NHS Acute Hospitals rated good or outstanding in the country.

The North Central London ICB area

• Had the lowest proportion of A&E attendances that became admissions to hospital in January 2023, and the highest proportion of A&E attendances from people who had been to A&E in the previous 7 days
• People who attended A&E and were later admitted waited for some of the longest times in the country to secure a bed, with 28% waiting more than 12 hours.

Adult social care providers want to work in partnership to provide care to more people

"[We have] regular care association meetings with LA's, working forums for recruitment workshops and sharing ideas. Financial sustainability remains unaddressed by my current area partnerships. Lack of engagement from ICS/ICB also. Financial impact remains a dirty word."

"We have been collating data in terms of long-term planning around budgeting, reducing energy, reviewing our respite bookings including our emergency respite, 1-1 support and the reduction to agency workers by recruiting permanent staff.​"

"The local authority is more willing to use our services although our rates are higher than contracted providers. However, the recent government funding - which LA's were given to try and impact on hospital discharge rates - ends at end of March, so totally unhelpful as I could not invest time and energy to develop something innovative since the funding was so short term.​"

Challenges remain around stability, staffing and commissioning

Our survey of adult social care services suggests some respondents are concerned about the viability and stability of their services.​

• 31% of respondents said they had concerns about the financial stability of their service.​

The survey results suggest that there is more capacity in the sector. Could capacity be unlocked by local system leaders?​

• 42% of respondents told us that they had between 11% and 100% unused capacity
• 28% told us their unused capacity was because of a "lack of commissioning"
• 26% said unused capacity was as due to "low staffing or recruitment and retention challenges".