Chris Morley (Locality Director for Plymouth, NHS Devon ICB) introduced the Winter Planning Update and discussed:

a)     Winter planning aimed to ensure robust plans were in place across health and social care to maintain flow and service delivery during the winter period and anticipated pressures;

b)    The presentation outlined University Hospitals Plymouth’s (UHP) winter plan, noting that this was a collaborative effort across partners, including Livewell Southwest and Plymouth City Council;

c)     Headline areas included social care preparations, market resilience, and the vaccination programme.

Michael Whitcombe (Deputy Chief Operating Officer, UHP) added:

d)    During winter 2024/25, bed occupancy rates had exceeded 98%, with an average of 40 patients remaining in the Emergency Department awaiting onward beds, and nearly 20% of patients experienced onward delays;

e)     Ambulance handover delays had resulted in over 7,500 hours lost, preventing crews from responding effectively in the community;

f)      The system was focused on meeting NHS England mandates, including delivering ambulance handovers within 30 minutes, improving Category 2 response times, and reducing 12-hour stays in the Emergency Department;

g)     The acute bed gap, if no action was taken, was forecast at 70–90 beds short within the acute trust. Seven workstreams were in place to address this, aiming for a 50% reduction, equating to 39 beds;

h)    Reducing length of stay by half a day could close the gap by 22 beds, supported by improved discharge processes and collaboration with community partners;

i)      Elective care would be maintained throughout winter and vaccination hubs were operational, aiming for a 5% increase in staff uptake and encouraging patient vaccinations;

j)      Current performance showed 72% compliance with the four-hour standard, a 6% improvement on last year, and ambulance handover delays had reduced by two-thirds in the last quarter.

Louise Ford (Head of Commissioning) provided an update on social care preparations and discussed:

k)     Work continued to ensure effective flow and commissioned capacity, including collaboration with Advice Plymouth and hospital discharge teams to streamline processes;

l)      Infection prevention and control measures were regularly raised with providers, alongside ensuring business continuity plans were in place;

m)   Additional work focused on demand and capacity planning, data integration for real-time forecasting, optimisation of brokerage functions, and oversight through the Integrated Commissioning Group;

n)    Winter plan actions included promoting vaccinations, supporting unpaid carers, and resilience-building for the care workforce.

Peter Collins (Chief Medical Officer, NHS Devon ICB), Rachel O’Connor (Director of Integrated Care and Partnership, UHP) and Ian Lightley (Chief Operating Officer, Livewell Southwest) added:

o)    The Devon-wide campaign went live on 01 October 2025, prioritising older adults and aimed for completion by the end of November 2025, with school programmes continuing until March 2026;

p)    Delivery models included GP sites, pharmacies, schools, acute hospitals, and targeted outreach for underserved communities.

In response to questions, the Board discussed:

q)    Concerns about ambulance delays and assurance that patients in ambulances received the same level of care as those in the Emergency Department, supported by HALO teams and rapid assessment nurses;

r)     The role of NHS 111 in winter preparedness, with improvements in clinical triage and signposting to alternatives to ED admission;

s)     Vaccination uptake challenges among health and social care staff, with Livewell reporting 40% uptake in 2024/25 and a target of 60% this year. Public Health confirmed national trends of declining uptake and committed to monitoring and tactical interventions;

t)     The need for data collection across providers to monitor vaccination uptake and address gaps, particularly among domiciliary care and voluntary sector workers;

u)    Assurance was sought that employers supported staff vaccination and that myths and resistance were being addressed through engagement and education;

Action: Requested that Public Health analyse data on health & social care staff vaccination, including across care markets, and report back to a future meeting;

Action: Requested that future reports include analysis of vaccination uptake and availability for the City’s ‘looked after children’.

Action: Requested that vaccination access and eligibility for voluntary sector workers (e.g., wellbeing hubs) is considered and reported to a future meeting.

The Board agreed:

1. To review, comment on, and endorse the plans set out in the Winter Planning report;

2. To receive feedback and updated data on vaccination uptake and winter preparedness at a future meeting.