NHS performance is “very likely to deteriorate further” under increased winter demand and industrial action, the Department for Health and Social Care (DHSC) briefing seen by the Observer reveals. It also warns of a possible increase in hospital admissions due to the cold weather and the rising cost of living. “If some people, especially the elderly, respond to higher fuel prices by turning down or turning off the heating, this could lead to increased admissions for heart attacks, stroke and respiratory disease,” the paper says. The 31-page update was leaked as the NHS faces some of the biggest strikes in its history and record waiting lists. More than 7.2 million people in England are waiting for routine treatment, the highest number since records began. Last month, 37,837 patients waited more than 12 hours to be admitted to hospital after the admission decision was made – a 255% increase on 2021 and 3,303% higher than November 2019. Among the measures ministers are considering to “build resilience” in the NHS are expanding efforts to recruit volunteers, strengthening ambulance crews and providing support to hospitals and the community. In August, the NHS launched a four-year, £30m contract with St John Ambulance to provide ‘hypertension capacity’ to 10 ambulance trusts and act as an official support service for England. Under the deal – the first of its kind – the charity provides at least 5,000 hours of support per month through crews with the ability to respond to the most urgent, life-threatening 999 calls. The leaked government document says plans to boost the voluntary workforce “will build on the approach recently agreed with St John Ambulance”. He adds: “We will build on the volunteers who already support the NHS and extend this further into local communities.” Thousands of volunteers were recruited during the pandemic to help deliver the vaccination program and volunteers are already providing behind-the-scenes support elsewhere in the NHS. However, the document sets out plans for a concerted effort to expand and extend their role at a time when essential services are struggling to find staff and are under increased pressure. The roles played by volunteers in the NHS vary from delivering medicines and driving ambulances to making beds for newly admitted patients and ‘general ward cleaning’. An advert, published by an NHS trust in the north of England, says it is looking for “urgent care and urgent care volunteers”, as well as people to volunteer on the 33-bed ward for cardiac patients and the elderly. There, duties for volunteers include “making sure patients stay hydrated, making sure hygiene needs are met … and basic clerical duties, including answering the phone,” she says. Miriam Deakin, director of policy at NHS Providers, which represents immediate, ambulance and other NHS trusts, said that while volunteers “always play a key role in the NHS” beyond core services, “there is simply no substitute for a properly staffed workforce. “. “There are 133,000 vacancies in the NHS at the moment. This needs to be urgently addressed by the government in the form of a fully funded, long-term workforce plan,” he said. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “What we need is a skilled and trained workforce to try to tackle the problems we have at the moment. It’s not just the boots on the ground – it’s also about the skill and training of the staff. “There is an evolving crisis in urgent care caused by a huge mismatch between supply and demand. There is too much work for our hospitals and our ambulance services, and the consequence of this is manifested in long ambulance queues outside emergency departments, but it is a sign of stress on the whole system. Hospitals are completely full right now.” Details of the plan to expand the voluntary workforce are set out in internal winter preparedness documents drawn up by civil servants for ministers in October. Archie Bland and Nimo Omer take you to the top stories and what they mean, free every weekday morning Privacy Notice: Newsletters may contain information about charities, online advertising and content sponsored by external parties. For more information, see our Privacy Policy. We use Google reCaptcha to protect our website and Google’s Privacy Policy and Terms of Service apply. The update paints a bleak picture of the challenges facing the NHS and its ability to cope, stating that waiting times for elective care and urgent and urgent care are already “far beyond typical” and winter 2022-23 ” will very likely see further performance degradation.” The document also states that “external threats and challenges could affect the health/life” of the population, “as well as add additional pressure to the functioning of the health and social care system”. The key threats are “industrial action, social care provider failure, power outages, extreme weather events and political unrest,” he says. An increase in other health issues linked to cold homes is also a cause for concern, with figures cited in the update suggesting that the death rate rises by 2.8% for every degree drop in temperature for those in the coldest 10% of homes . The health impact will likely be exacerbated by a decrease in the number of people spending money on medicine and nutritious food and an increase in mental health problems linked to debt, he adds. NHS England said it could not yet share further details of its plans to expand volunteering, but that it was “exploring options”. It has started discussions with the 42 integrated care systems in England to create volunteer roles that will be “designed and mobilized to meet local priorities”. says the volunteering program is now being reshaped “for the long term” and will be “reshaped to help the NHS support people’s needs, locally and nationally”. More volunteers will be recruited and “additional roles” will be created, he says. Separately, NHS England has published advice for trusts on how to manage pressure on services over the winter, which includes ordering them to consider commissioning voluntary organizations to help respond to 999 calls about “level drops” two”. These include cases where patients have a minor injury or pain and further clinical assessment is required, but the injuries are not life-threatening. NHS guidance from 2017 says volunteers do not replace paid staff and play a different role. They have no contracts and the tasks they perform are based on “mutually agreed expectations”. Wes Streeting, Labour’s shadow health secretary, said increasing reliance on volunteers was “not a long-term solution”. “The NHS clearly needs all hands on deck this winter because of the Conservatives’ failure to train enough staff over the last 12 years,” he said. The DHSC said: “We are very grateful to the selfless people who volunteer in the NHS, but we know that the NHS needs further support. That’s why we prioritized health and social care in the Autumn Statement with up to £14.1 billion over the next two years and announced a new recovery task force to further tackle the delays caused by the pandemic.” .
