ten - Reflections on an evaluation of partnerships to cope with winter pressures

Summary

Introduction

This chapter reflects on an evaluation of partnership working between health and social care services in West Sussex. In evaluating projects to combat ‘winter pressures’, it outlines the mapping of the main relationships between stakeholders, findings from a questionnaire sent to senior, middle management and frontline staff and an analysis of evaluation forms. It shows how national policy drove the projects and how local politics contributed to as well as impeded their success.

Winter pressures are governmentally recognised special problems experienced in winter by both health and social services as a result of a higher incidence of illness, especially among older people, and a consequent increase in emergency admissions. Special funding to meet these pressures was introduced in 1997 for local health and social care communities through Local Winter Planning Groups (LWPGs).

The LWPG provided a prime example of partnership working. Its broad representation included the relevant Health Authority, Social Services Departments, Trusts (acute, mental health, community, learning disability and ambulance services), Primary Care Trusts and Groups, Local Representative Committees, Out of Hours’ Cooperatives, Deputising Services, NHS Direct, Community Health Councils (CHCs)/Patient/Public representatives and members of the voluntary and private sectors involved in health and social care.

National criteria for local winter planning required each health and social care community to submit a single local winter plan to its health and social care region at the end of the July of that year for agreement by the end of September (DH, 2000). In 2000 national criteria focused on flu immunisation, hospital services (critical care and acute services), community and mental health services, ambulance services, intermediate care, social care and primary care. Further issues covered included contingency plans for escalation/control procedures, human resources and communications.

Six broad areas of action being taken to prepare for winter, as set out in the ‘Winter Plan’

• • Promoting self-care and preventing ill health;

• • investment in capacity and change;

• • service improvement and design;

• • staffing;

• • better preparations and strengthened partnerships; and

• • managing the winter.

The Winter Report 2000-01 found many examples of good progress, as well as areas still requiring considerable attention. Its recommendations, however, signalled a greater focus on year round capacity planning as the key to improved services:

Local planning for winter should explicitly include preparations to manage elective as well as emergency demand. LWPGs should operate all year round. (DH, 2001a, para 58)