Health bosses are already seeing increased demand for hospital services in Staffordshire and Stoke-on-Trent before the start of winter, it has been revealed.

Last winter University Hospitals of North Midlands (UHNM) NHS Trust, which runs Royal Stoke and Stafford's County Hospital, faced challenging conditions, with critical incidents declared in December and January.

Health services began preparing for the latest winter season several months ago. And on Monday (November 10), members of Staffordshire Council's Health and Care Overview and Scrutiny Committee were given details of the Staffordshire and Stoke-on-Trent Integrated Care System Winter Plan.

Monday's meeting heard that the past three weeks have been "incredibly pressured" for acute health services in the area.

The opening of additional capacity at Royal Stoke University Hospital and Stafford's County Hospital has been brought forward.

Hayley Allison, portfolio director for delivery and improvement at Staffordshire and Stoke-on-Trent Integrated Care Board said: "A key feature of our winter plan this time around has been how we learn from what we've done – we've had some really difficult winters.

"How do we make sure patients receive care in a timely way when they go into an A&E department.

"The national target is for them to receive care, be assessed and treated within four hours. At the moment, we're not achieving the national standard.

"What does a good winter look like? For me it's good access, timely assessment and treatment – and also, more importantly for patients, it's to receive care in the right place.

"You will all know about infection prevention and control for things like Covid, norovirus, RSV and flu – all of those things we see in a much more increased way through the winter period.

"What's happened in previous winters is we've had all of those infections happen at the same time, so that puts incredible pressure on the NHS.

"Last winter we had a number of critical incidents which were in response to issues with capacity and demand. When we go to a critical incident that's when we have to look into what additional actions we can undertake and they're usually very extraordinary actions so that we can maintain safety for our patients.

"We've taken all that learning from those critical incidents that took place last year to develop our plan. We've picked out things we need to do differently".

Alternative options to hospital were being considered for patients when assessing them, committee members were told.

An integrated care co-ordination centre (ICC) is providing a single point of access for clinicians.

Ms Allison said: "For example, if an ambulance crew were at a patient's home assessing whether they needed to go to hospital, the ICC could support with identifying whether there is an alternative. We started out with an ICC 12 hours a day and earlier this year we extended that to 24 hours a day.

"Each day we have a significant number of patients that are redirected away from hospital settings – they access care in the right place.

"They might have a community team come in to see them, they might go onto a 'virtual ward' or they might be seen by primary care.

"It's been a real success for us. And one of our intentions through winter is to increase capacity in the ICC so that more patients can be redirected from going into hospital where not appropriate to do so. "

The issue of ambulance handover delays at hospitals across the region had been raised earlier in the committee meeting.

Members were told that West Midlands Ambulance Service was facing the worst level of handover delays in the country "by some margin" – and In October alone, crews lost 41,000 hours waiting outside hospitals across the region to transfer patients.

Ms Allison said: "It is fair to say we have some inappropriate conveyances and we're working really hard to learn and understand why that happened.

"We've introduced a weekly clinical review of patients that have been identified as conveyed inappropriately to the hospital so we can understand was there a reason, was there a lack of access into something like the ICC.

"In the winter plan we have funded things like additional primary care appointments – we hear at times about primary care access not being where it needs to be so that's been a core feature. It's increased capacity in community settings, for example increased capacity in Cheadle."

The importance of vaccination take-up was also highlighted.

Ms Allison said: "We know that if we could do better in the vaccination programme and more patients could access that, then that would in turn reduce the number of patients that end up being seriously unwell and requiring a hospital admission.

"If UHNM (University Hospitals of North Midlands NHS Trust) were in the room with us today they would talk about last year.

"There were a number of patients that went into the hospital setting, perhaps for an outpatient appointment, that were exposed to flu virus and that cohort of patients then converted into being admissions into hospital a number of weeks later.

"Our focus on vaccination (includes) additional resources into making sure patients going back into the care home setting are vaccinated, patients that are coming in for an outpatient appointment are offered the vaccine.

"Then of course you have vaccination routes through primary care or pharmacy-type provision as well."