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

Ensure people receive the right care, in the right place at the right time, prioritising care at home, or as close to home as possible, where clinically appropriate

The principle that people should receive the right care, in the right place at the right time is one which underpins all our health and social care services at all times. It is important this is maintained during periods of surge in demand, not only because it is better for individuals, but also because maintaining effective patient flow to the right services helps manage overall demand.

For many, emergency departments may not be the best place for their healthcare needs and alternative routes to urgent care is required. A ‘home first’ approach is not only better for people but reduces pressure on acute and primary care services too. Surge planning should include avoiding unnecessary hospital admission wherever possible by reducing transport of people from care homes where it is clinically appropriate, continued focus on hospital at home services and discharge to assess where available.

The principle of right care, right place, right time does not just apply to health care however, we know that it is also important to apply this principle to social care and social work assessments, as assessments are most effective when completed in a person’s own home. Often during period of exceptional demand, individuals with ‘critical’ or ‘substantial’ social care needs are prioritised for support, but we know it is also important for people with lower or moderate levels of risk to be signposted to appropriate support as well. During these times, thresholds for accessing care and support may need to shift in order to ensure those most at risk of harm or loss of independence are able to get the care they need. This should be continuously evaluated and HSCPs should seek to ensure that resources are not narrowly focused on those with the most acute needs, and that individuals accessing care and support are able to do so with choice, control, and dignity. HSCPs should ensure strong collaboration with their local and national voluntary sector partners to promote access to lighter touch, preventative, community-based support.

During periods of surge, it is important to maintain the principle of parity between physical and mental health and ensure that those in need of emergency mental health care must receive support quickly, and wherever possible, close to home. Where appropriate, people presenting with stress and/or distress should be treated in a community setting that supports the patient instead of in hospital as default. This will also ensure that people seeking mental health support receive the right care, in the right place, at the right time, regardless of where, or what time of day they present.