Health and social care - surge preparedness: national planning priorities and principles

Section 4: National Priorities

Purpose

The National Priorities set out the key outcomes that local systems should seek to deliver through preparedness, resilience, surge and winter planning. They describe what local systems should focus on achieving to support safe, effective, person-centred and sustainable health and social care services during periods of normal operation and increased pressure.

The priorities provide a focus on improving outcomes, reducing inequalities, strengthening resilience and ensuring people receive the right care, in the right place, at the right time. They should be embedded within local planning, delivery and improvement arrangements and implemented in a way that reflects local needs, circumstances and risks.

Priority 1: Prioritise Care for People Most at Risk

Why this matters

Periods of increased pressure can have a disproportionate impact on people with complex health and social care needs, long-term conditions, frailty, disability, poor mental health and those experiencing disadvantage or inequality. Early identification and proactive support can improve outcomes, reduce avoidable deterioration and help people remain independent for longer.

Planning should be informed by population need, local intelligence and an understanding of health and healthcare inequalities, ensuring that resources and interventions are targeted towards people and communities most at risk of poorer outcomes. Consideration should include deprivation, rurality, protected characteristics and other factors that may affect access to care, experience of services and health outcomes. By taking an equitable and proportionate approach, local systems can help reduce inequalities and ensure support is directed to those who would be most affected by service disruption or deterioration in health and wellbeing.

Key Expectations

Local systems should:

• Identify and support people at greatest risk of deterioration, admission or delayed discharge.
• Use population health management and local intelligence to inform planning and delivery.
• Ensure planning and delivery are informed by population need, deprivation, rurality, protected characteristics and other factors associated with health and healthcare inequalities.
• Target interventions and resources towards individuals and communities at greatest risk of poorer outcomes.
• Support integrated, place-based approaches to care and support.
• Promote equitable access, independence, wellbeing and person-centred outcomes.

Priority 2: Prevention, Future Care Planning and Early Intervention

Why this matters

Prevention is fundamental to improving population health, reducing inequalities and strengthening resilience across health and social care services. Effective preventative approaches can reduce avoidable deterioration, crisis, admission and demand while improving outcomes and supporting independence.

Preparedness arrangements should promote anticipatory care, future care planning, vaccination, self-management and timely access to support. Prevention should be viewed as a whole-system responsibility supported by primary care, community services, public health, social care and community partners.

Key Expectations

Local systems should:

• Strengthen anticipatory care and future care planning arrangements.
• Maximise uptake of relevant vaccination programmes.
• Support self-management and early intervention approaches.
• Integrate primary care within preparedness and resilience planning.
• Promote community-based support that helps people remain well and independent.
• Reduce avoidable deterioration, attendance and admission wherever possible.

Priority 3: Support Public Understanding and Access to Care

Why this matters

Supporting people to access the right care, in the right place, at the right time helps improve outcomes, reduce delays and maintain capacity across the wider health and social care system. Clear communication and effective navigation become increasingly important during periods of heightened demand.

People should have access to timely, accessible and consistent information to help them understand available services and make informed decisions about how and when to seek support. Local and national communications should work together to promote awareness of urgent care pathways and alternatives to hospital attendance.

Key Expectations

Local systems should:

• Promote public understanding of urgent and emergency care pathways.
• Support appropriate use of NHS 24 and the 111 service.
• Improve awareness of available primary care, community and mental health services.
• Provide clear, consistent and accessible communications.
• Utilise local and national communication channels effectively.
• Monitor the impact of communication and navigation initiatives.

Priority 4: Ensure the Right Care, in the Right Place, at the Right Time

Why this matters

A Home First approach should underpin preparedness and resilience planning. People generally achieve better outcomes when supported to remain at home or return home as soon as clinically appropriate. Delivering care at home, or as close to home as possible, can improve outcomes, reduce unnecessary admissions and support recovery and independence.

Preparedness arrangements should maximise community-based alternatives to hospital admission and support effective transitions of care across organisational boundaries.

Key Expectations

Local systems should:

• Embed Home First approaches within planning and delivery arrangements.
• Maximise the contribution of Hospital at Home services.
• Strengthen Discharge to Assess approaches.
• Support effective rehabilitation, reablement and intermediate care services.
• Utilise step-up and step-down models of care where appropriate.
• Promote recovery, independence and timely discharge.

Priority 5: Maximise Capacity, Flow and System Resilience

Why this matters

Maintaining effective flow and access to care is critical to supporting resilience across health and social care services. Pressures within one part of the system can quickly affect capacity and performance elsewhere, making coordinated whole-system action essential.

Preparedness arrangements should support proactive management of demand, timely discharge, effective operational decision-making and protection of essential services. They should also utilise operational intelligence and data to anticipate pressures and support appropriate escalation where required.

Key Expectations

Local systems should:

• Improve flow across health and social care services.
• Reduce delayed discharge and minimise barriers to timely discharge.
• Address delays associated with Adults with Incapacity processes and complex discharge pathways.
• Use operational intelligence, forecasting and predictive analysis to support decision-making.
• Maximise the use of digital and virtual approaches to care.
• Protect planned care, cancer services and other time-critical pathways wherever possible.

Priority 6: Strengthen Workforce, Carer and Community Resilience

Why this matters

The workforce is the most important enabler of safe, effective and sustainable services. At the same time, unpaid carers, social care providers, community organisations, volunteers and the third sector make a critical contribution to supporting people and maintaining resilience across local systems.

Preparedness arrangements should support workforce wellbeing, sustainability and flexibility while recognising the contribution of carers and community assets in preventing deterioration, supporting recovery, enabling discharge and sustaining independence.

Key Expectations

Local systems should:

• Support workforce wellbeing, resilience and sustainable working practices.
• Strengthen workforce planning, mobilisation and surge capacity arrangements.
• Promote recruitment, retention and workforce development.
• Recognise unpaid carers as essential partners in care and resilience.
• Support access to information, advice and support for carers.
• Maximise the contribution of community capacity, social care and third-sector partners.