Winter pressures and scrutiny
It’s that time of year. The clocks have changed, the days are getting shorter, traditional Christmas music enhances our shopping experience…
Soon we can expect to start hearing about ‘leaves on the line’ or ‘the wrong kind of snow’ or other circumstances that tend to annually disrupt our lives and which, on the face of it, seem to defeat the best efforts of service providers.
Of course, it’s important to get these circumstances in perspective, because a late train or congested car journey are not the worst of life challenges in social or global terms. But understanding risks and building resilience is a critical role for people who plan and deliver services, to make sure that vulnerable people are protected and to lessen the negative impact on local economies.
This is especially important in health and social care, where the winter months can represent the most challenging times for local health and care systems and the additional pressures can result in poor outcomes for many people if they experience longer waits for urgent care/accident and emergency services, cancelled operations or delays in being discharged from hospital.
Building system resilience can help overcome potential difficulties and our new guide, Winter Pressures, A Guide for Council Scrutiny, aims to help councils consider how to use their scrutiny function to bring leaders together from across whole health and care systems to review system resilience, not just at wintertime but throughout the year.
The circumstances that cause risks to resilience may not be the same in every area, for example demographic or structural factors – diverse or dispersed populations or increased visitors at certain times of year. It’s important that councillors involved in scrutiny ask questions about the local context but also find out about recognised national actions that improve resilience and test whether those might work in the local situation.
For example, there are some actions that are recognised nationally as being likely to improve urgent and emergency care and transfers of patients between hospitals and home or social care services. Data can provide an early warning of pressures building in local systems – but behind data and targets are the experiences and stories of patients and their families and carers.
Council scrutiny can be a bridge between the people who plan and deliver services and the people who use services. With social care and NHS budgets under pressure there are no easy solutions, but we hope our guide inspires councils to use scrutiny to help tackle winter pressures and resilience more generally.
About the Author: Tim Gilling
Tim is a Director at the Centre for Governance and Scrutiny, leads on health and social care and oversees our work in Wales, Scotland and Northern Ireland.
