UHUK responds to The Health Foundation Report on Winter Pressures
The Health Foundation’s latest analysis highlights the significant pressures experienced across the NHS this winter. While delayed discharge remains a major challenge, effective management of demand at the hospital front door is also critical to maintaining system flow.
Across Urgent Health UK (UHUK), our members are delivering proven interventions that ease pressure by preventing unnecessary hospital use and by supporting earlier, safer discharge when admission has been necessary.
This paper shares practical insights from UHUK members on what is working now — and how these proven models could be scaled to support a more resilient NHS.
Understanding the Challenge
The Health Foundation report rightly emphasises that delayed discharge is now
one of the most significant threats to NHS hospital capacity. Patients ready to
leave hospital are often unable to do so due to shortages in community care and
rehabilitation services.
At the same time, reducing the number of avoidable hospital admissions remains essential. Each patient who can be safely treated outside hospital protects critical bed capacity for those with the most complex needs.
Both demand management and discharge improvement are necessary — and must be supported by stronger system leadership, commissioning,and operational coordination.
Proven Interventions to Prevent Unnecessary Admissions
Across UHUK members, a range of urgent and primary care services are demonstrating real-world impact by preventing avoidable hospital attendances and admissions. These services offer patients timely, high-quality care in the community, reducing pressure on emergency departments and acute beds.
UHUK members provide a wide range of urgent and primary care services, including NHS 111, Clinical Assessment Services (CAS), virtual wards, palliative care, GP Out of Hours (OOH), Urgent Treatment Centres (UTCs), and A&E triage and treatment.
These services are delivered in patients’ homes, in treatment centres, and in the community, in partnership with local NHS teams and operating 24/7 to meet urgent care needs around the clock.
These interventions show that when accessible, well-integrated urgent care options are available, hospital flow improves — even under winter pressures.
Case Study Integrated Care 24's Unscheduled Care Co-ordination Hub,
In partnership with Norfolk and Waveney ICB, Integrated Care 24 developed an Unscheduled Care Co-ordination Hub which brings together GPs, paramedics, nurses, mental health teams, and social care providers to ensure patients receive the right care, in the right place, first time.
Since launching in September 2023, the UCCH has reviewed over 25,770 emergency calls—preventing ambulance dispatch for 63% of cases and enabling 16,987 patients to stay safely at home without the need for an ambulance attendance. This is especially vital for older patients at risk from long waits and unnecessary admissions.
The hub has already been recognised by Health Service Journal Partnership Awards – winning the award for Best Contribution to the Improvement of Urgent and Emergency
Care.
Case Study: FCMS develop new or enhanced services to reduce pressure on ED &
Ambulance Trusts
During the period November 2024- February 25 FCMS delivered services that have
been specifically developed, or enhanced, to reduce the pressure being felt by
Emergency Departments and Ambulance Trusts in the areas they serve.
- FCMS’ five urgent treatment centres/Same Day Health Centres across Doncaster and Lancashire saw a total 77620 patients.
- On the Fylde Coast in the Northwest of England, FCMS’ Alternative to Transport; Paramedic on Scene service was consulted 2093 times, resulting in a deflection rate of 94%, meaning that 1968 patients were not transported to the Emergency Department unnecessarily and were cared for in other ways.
- In Doncaster, FCMS’ Acute Respiratory Infection hub saw 7373 patients with 57% of referrals into the service coming direct from GP Practices and 43% coming from NHS111. The hub intercepted and treated patients in the community rather than them attending ED
or being admitted to Respiratory Wards; this work has been calculated to create a saving of circa £1.3m to the local health economy.
- FCMS extended the code set ofNHS 111 dispositions that could be directed to their 3 Lancashire Urgent Treatment Centres, resulting in an average increase of 9.5% in
referral rates to those services in cases that would previously have been directed to ED.
- Working hard with Ambulance Trust colleagues at NWAS and YAS, by validating category 3 and 4 ambulance calls prior to dispatch, 65-70% of validations resulted in stopping the dispatch of an ambulance and engaging other services to manage patients in alternative ways.
Proven Interventions to Support Earlier Safe Discharge
UHUK members are also supporting earlier and safer discharge through innovative at-home models of care, ensuring patients can leave hospital once their acute care needs have been addressed.
Key interventions include:
- Virtual Wards and Remote Monitoring: enabling hospital-level observation and care at home, freeing up acute beds more quickly.
- Community Diagnostics and Follow-up Services: providing timely post-discharge support and reducing the risk of readmission.
Case Study: DHU Healthcare - Proactive Monitoring Prevents Admission
Overview:
An 81-year-old gentleman was referred to the Community Virtual Ward (CVW) via
the Central Navigation Hub following episodes of dizziness. He had multiple
comorbidities, including hypertension, obstructive sleep apnoea (on CPAP),
chronic nasal congestion, and cognitive impairment. Recently bereaved and
living alone with only family support, he was at risk of deterioration.
Intervention:
A CVW Advanced Practitioner conducted a home visit and identified that
dizziness occurred approximately one hour after taking a beta-blocker. Initial
observations and an ECG were completed, with no immediate postural drop
detected. Twice-daily monitoring was initiated. Nasal congestion was treated,
and the beta-blocker dose was reduced, with a follow-up ECG planned.
A repeat ECG seven days later revealed a 2:1 heart
block. Although the local Cardiology Virtual Ward could not accept a direct
referral, the patient's GP was contacted, an ECG was emailed, and a formal
referral was made for a 24-hour tape and consideration of a permanent pacemaker
(PPM). Blood pressure continued to be monitored while awaiting cardiology
input.
Outcome:
The patient remained safely at home throughout, with no further falls reported.
Ongoing reassurance and support were provided, and investigations by Cardiology
are now in progress.
These services not only support better system flow but also align with patients’ preferences to recover at home wherever possible.
Lessons for Scaling Proven Models
The success of these interventions points to clear lessons for wider system
improvement:
- Integrated Urgent and Community Care Pathways:bringing services together around patient need.
- Investment in Digital Solutions: to enable remote triage, monitoring, and shared decision-making.
- Supportive Commissioning Structures: ensuring sustainable funding for hospital avoidance and discharge services.
- Stronger System Leadership: ensuring innovations are consistently embedded across Integrated Care Systems (ICSs).
UHUK members have seen that where these enablers are present, urgent and emergency care systems are more resilient, and patients experience better outcomes.
Conclusion
The NHS does not need to start from scratch to ease winter pressures —proven interventions already exist.
Urgent Health UK members are delivering practical, scalable models that prevent avoidable hospital use and enable earlier, safer discharge.
We’re already working with local partners — and we’re happy to share what’s working, where, and why.
As the Health Foundation rightly points out, there’s a growing need for a better understanding of what works and how these interventions can be implemented effectively. UHUK members are not only delivering these models but are also well placed to support national efforts to spread the learning and scale success.