Help Us Help You this winter

Winter plan evaluation

Data up to the end of March 2024, highlighted the positive and significant impact of Mersey Care’s Winter Plan. Overall, across our service delivery, more than 57,000 potential bed days have been saved, 26% more than originally planned.

Particular areas that have contributed to this year’s impressive results, include increased numbers of 2-hour urgent community response referrals compared to the previous year, and community mental health teams working alongside urgent care colleagues to reduce pressures within A&E departments.

Despite decreases in referrals to COVID related services such as nMABS, there has been significant increases in the numbers of patients managed via respiratory and heart failure Virtual Wards.To put into context, the overall number of bed days saved is equivalent to 313 beds provided for within the community – 65 more than the original plan.

Once again, this year’s winter plan was supported by a successful communications and marketing campaign:

September 2022 saw the opening of the New Royal Hospital in Liverpool. It is likely to be an even more challenging winter in 2023-24 with a further reduction of between 120-150 beds across Liverpool University Hospitals NHS Foundation Trust (LUHFT). 

The rising rate of inflation is adding significant pressure to an already stretched health and social care system.  A potential scenario of lack of heating and less than adequate nutrition will affect many people this winter. 

Significant demand for mental health services is expected to continue post COVID.  We continue to see extreme pressure on our urgent mental health services, as well as rising demand for planned care and lower level mental health interventions. 

The challenged areas for winter 2023-24 are expected to be:

• Crisis Line
• CORE24
• Triage Car
• Community Mental Health Teams (CMHT’s)
• Criminal Justice Liaison
• NHS Talking Therapies (previously known as Improving Access to Psychological Therapies (IAPT)
• Early Intervention Psychosis (EIP)
• Eating Disorders 
• Step Forward.

Winter demands seem to be the new starting baselines for the rest of the year meaning 2023-24 will be another significant challenge.

This Winter Plan is designed to address the immediate resilience challenges of winter and the significant changes to the acute bed base across the system, whilst recognising our vision to provide Perfect Care that enables people with physical health and mental health conditions, learning disabilities and addictions to live longer and healthier lives.

The key elements of our strategy that underpin this Winter/Resilience Plan are:

• We will take an even more preventative approach, taking a population health-based approach to understanding and anticipating the needs of different population groups, supporting people in community settings and where possible their own home, and working with our partners to do this.
• We will significantly increase care coordination for people with complex needs, particularly at points of transition, and reduce hand offs and points of assessment, working closely with partners to delivered joined up care. We will tailor our services to meet people’s needs, particularly as demand for our services increases. We will use evidence-based risk stratification to personalise care according to people’s needs.
• We will use digital technology as a key enabler of our effort to meet people’s needs, to help us overcome workforce shortages and increase the patient independence threshold with remote monitoring that allows them to feel more secure.
• We will prepare our services to support the maximum amount of people to stay in the community and not require to be admitted to an acute or Mental Health inpatient bed.  If they do, we will play a significant role in getting them discharged safely and minimise their time away from home.

The key priorities for 2023-24 have been identified across the Trust and are categorised into the following five themes:

• Agility and responsiveness.
• Avoiding Attendances and Admissions
• Discharge and Flow
• Better Co-ordinated Care
• Prevention and Protection and Staff Wellbeing.

Our Winter Resilience plan for 2023-24 looks to increase its system impact by up to 15% compared to last year.

You can view the plan here.

The UK Health Security Agency has reported an increase in measles across the country including in the North West and is encouraging people to check that they and their children have had two doses of the MMR vaccine.

The free MMR vaccine is a safe and effective way of protecting against measles, as well as mumps and rubella.

It’s important for parents/ carers to take up the offer of MMR vaccination for their children when offered at 1 year of age and as a pre-school booster at three years, four months of age. If children and young adults have missed these vaccinations in the past, it’s important to take up the vaccine now from GPs, particularly in light of the recent cases.

Check your child’s Red Book to see if they’ve received MMR vaccinations as scheduled or check with your GP surgery if you’re unsure. Most healthy adults will have developed some immunity to measles but can still receive two doses of the vaccine from their GP too.

Anyone with symptoms is also being advised to stay at home and phone their GP or [nhs.uk%20website.]NHS 111 for advice.

Measles symptoms to be aware of include:

· High fever

· Sore, red, watery eyes

· Coughing

· Aching and feeling generally unwell

· A blotchy red brown rash, which usually appears after the initial symptoms.

For more information about measles, see the nhs.uk website

Cold weather can make some health problems worse and even lead to serious complications. This is why staff are thinking about what they can do to ensure patients and service users are able to keep warm this year.

Did you know that the Institute of Health Inequality forecasts that there are likely to be 13,545 additional deaths in England alone this winter, due to people living in cold homes?

What can I do?

There are five things that you can do to help:

     1. Look out for patients living in cold homes below 18ºC: In appointments, on home visits and when discharging people from inpatient stays consider: is this person returning to a cold home? Do they have the means to heat their home?

      2. Think about people who might be particularly vulnerable: including those with heart or lung conditions, the elderly, those living in fuel poverty or those who have problems communicating their needs to others.

      3. Offer immediate advice: about how they can keep warm by: -

• Wearing layers, including thermal vests, or items made of wool or cotton
• Having regular hot drinks and trying to eat at least one hot meal a day
• Keeping moving
• Heating one room at a time and spending most time in there
• Closing curtains at dusk and keeping doors closed between rooms
• Blocking draughty areas such as window frames, keyholes and under doors
• Closing bedroom windows at night, switching from summer to winter duvets and using hot water bottles or electric blankets to keep warm in bed
• Finding out where their local ‘warm space’ is: https://warmspaces.org/
• If they are over 65, not very mobile or have a health condition try to support them to access the means to heat their home to over 18ºC
• Check whether they have received the Winter Fuel Payment or are entitled to a Cold Weather Payment from their local council (see details below)

     4. Signpost to organisations

• Winter fuel payments: www.gov.uk/winter-fuel-payment 0800 731 0160
• Cold weather payments: www.gov.uk/cold-weather-payment
• Energy saving advice:  Energy saving advice - Help for Households
• National Save Energy Advice Line: 0800 043 0151

     5. Read more: about keeping warm and well in Winter

• British Heart Foundation’s advice for cost effective ways to keep the heat in.
• St Helens Winter Well Strategy:
• Warm_Home_and_Winter_Wellbeing_Guide.pdf (gosshosted.com)

Local resources:

St Helens Council's website and Warm Spaces

Sefton Council's warm spaces

Knowsley Council's website and Warm homes referral 

Halton Council's website

Liverpool Council's website

Warrington Council's website

GOV.UK - top tips for keeping warm and well this winter

Emergency power cuts are unlikely this winter, however if they do occur, it’s expected that loss of power could be for up to three hours, and this may happen more than once depending on the situation. For further information see the leaflets below:  

• Preparing for winter – general advice
• Power cut advice for care homes
• Business toolkit

The NHS App gives you a simple and secure way to access a range of NHS services. Download the NHS App on your smartphone or tablet via the Google play or App store. You can also access the same services in a web browser by logging in through the NHS website.

You must be aged 13 or over to use the NHS App. You also need to be registered with a GP surgery in England or the Isle of Man. Find out more about who can use the NHS App. 

Depending on your GP surgery or hospital, you may be able to use the NHS App to:

• Message your GP surgery or a health professional online
• Contact your GP surgery using an online form and get a reply
• Access health services on behalf of someone you care for
• View and manage your hospital and other healthcare appointments
• View useful links your doctor or health professional has shared with you
• View and manage care plans
• Estimate the waiting time for some hospital treatments

For more information including how to download the NHS App, visit the NHS website.

The Adverse Weather and Health Plan

The Adverse Weather and Health Plan has been developed in conjunction with the Met Office, NHS, Voluntary Sector, Fire Services and Local Authorities and aims to protect individuals and communities from the health effects of adverse weather and to build community resilience.

Useful websites

• The Met Office - be weather ready

• Supporting vulnerable people before and during cold weather: healthcare professionals