Bexley is bracing for a challenging winter in healthcare, with a report presented to the Adult Social Care & Health Overview and Scrutiny Committee highlighting potential funding shortfalls, staffing pressures, and capacity concerns at local hospitals. The Bexley Wellbeing Partnership's winter preparedness plan for 2025/26, detailed in the BexleyWinterResilience OSC Report202526 [http://democracy.bexley.gov.uk/documents/s120186/Item%2005-%20BexleyWinterResilienceOSC%20Report202526V4.0%201.pdf], outlines key challenges and proposed actions to mitigate risks.
Demand for services is expected to outstrip capacity, particularly in adult social care to support hospital discharges, district nursing, and emergency department and bed availability at Queen Elizabeth Hospital (QEH). The report indicates that funding to Adult Social Care to support discharge flow is limited and at risk of demand outstripping funding, potentially leading to hospital discharge delays and impacting hospital flow and patient outcomes. Furthermore, local allocations for winter are predominantly non-recurrent, which limits the ability to embed workforce and sustain change.
To address these issues, the Bexley Wellbeing Partnership is building upon its Urgent & Emergency Care Recovery Plan for 2025/26 and developing a collaborative winter plan. This plan builds upon learning gleaned from in-year events such as 'Super March' and the Better Care Fund programme. The plan also aims to support appropriate admissions and expedite safe discharges, and the specific deliverables for 2025/26 have been aligned to the requirements set out in the NHSE Urgent and Emergency Care Plan 2025/26 which require a whole system approach focusing on enhanced community based urgent care, optimising A&E flow, Same Day Emergency Care, improving internal flow, and safe and timely discharge. Prioritising risk management and deploying the local Rapid Response team are also key components of the strategy.
Specific measures are being taken to increase capacity in adult social care to support hospital discharges. These include improved lengths of stay in step down beds, purchasing additional equipment to be readily available in stores for discharge, use of the Disabled Facilities Grant to provide home adaptations, ongoing dedicated support to patient flow by reconfiguring staff roles and responsibilities, continued provision of weekend on-call support enabling packages of care to be in place over the weekend period, and funding for an additional six spot purchased beds on a short-term occupancy basis. This will reduce length of stay and free up acute bed capacity during the winter period.
Prevention and primary care measures are also being prioritised. These include Access Improvement Plans by the four Bexley Primary Care Networks (PCNs), the Pharmacy First service, Enhanced Access to primary care, and a comprehensive vaccination programme. The Bexley Health Neighbourhood Care CIC will manage the two Urgent Treatment Centres at Erith & District Hospital and Queen Mary's Hospital, Sidcup.
The Better Access Bexley campaign will continue to promote ways for residents to access primary care services. Support for unpaid carers will also be highlighted, including the 'Carers' Corner' in the Thamesmead Library, located in the Nest Community Centre.
Community, adult, and mental health services will also play a crucial role. The Home First principles, emphasising recovery in the patient's own home, will be reinforced. Other services include Emergency Department Care Navigators at Queen Elizabeth Hospital, Virtual Wards, the Rapid Response Team, the NHS 111 'Press 2 for mental health' service, and the Mental Health Crisis Cafe.
The success of the Bexley Wellbeing Partnership's winter preparedness plan will be measured against key performance indicators (KPIs), including a minimum of 78% of patients who attend A&E being admitted, transferred or discharged within 4 hours, and reducing ambulance wait times for Category 2 incidents from 35 to 30 minutes.
