NHS - planning for winter already

It's June, with some of the hottest weather seen in decades - but the NHS is already worrying about the winter. Sounds odd, but hospital leaders in England argue that if decisions aren't made soon, it will be too late to inject money in a way which will make a difference when the temperature falls and emergency admissions start rising.

There is a hint of familiar special pleading in a new report from NHS Providers - which represents hospital, mental health, community and ambulance trusts in England.

The organisation has called frequently for more money for the NHS, and there is a tendency for its warnings about underfunding to be dismissed in Whitehall as "same old, same old".

But the NHS Providers' call for more cash for this winter comes in a year with a tight financial settlement, where funding for NHS England is rising by just over 1% - considerably less than the previous year.

Once again, budget increases will lag well behind anticipated demand. The organisation argues that there were "unacceptable levels of patient risk" last winter, with "unsafe" levels of bed occupancy at times.

Boost social care

NHS Providers makes the point that the government's commitment of £1 billion extra for social care funding in England this year was partly aimed at easing the pressure on the NHS.

The idea was that if elderly patients could be moved more swiftly out of hospital, then beds could be freed up for new admissions.

But a survey of its members suggests that only 28% of trusts have had a clear commitment that the money will be used to reduce the delayed transfers of elderly patients from hospitals to social care.

Little more than a third report that local authorities are giving a high priority to support the NHS in reducing delayed transfers.

The Local Government Association has rejected the trusts' concerns, arguing that the survey was carried out before the detailed plans for the extra social care funding were finalised.

It also points out that there are other areas in need of higher investment, such as supporting those with disabilities, and the money was not supposed to be solely focused on relieving winter pressures.

But, in essence, hospital representatives are saying that if the new social care money does not help free up many beds, there will have to be other sources of support to help the NHS navigate a difficult winter.

Wish list

On the NHS Providers wish list is an extra £350 million from the government for the winter months. This would be spent on extra staff and increasing beds in community facilities.

NHS Providers members claim that they need to know by July at the latest whether any extra money will appear.

That gives time for the recruitment of temporary staff and investment in more bed capacity. Winter funding promised in the autumn will be too late.

The Department of Health says £100 million more has already been invested in reducing pressure on hospitals in England, and the NHS and local councils will be expected to work together to ensure people are not stuck in hospital unnecessarily.

Ministers, preoccupied with the Queen's Speech and Brexit, may feel winter is some way off and not an urgent priority.

But if NHS Providers are right, the window for winter planning is getting smaller every week.