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by Ebony Armitage, Principal Category Manager – Construction & Estates NHS Shared Business Services. |
Since the end of 2024, the NHS has continued to face rising pressures, despite over 27 million successful vaccinations for flu, Covid-19 and RSV. As the days grow shorter and temperatures drop, the NHS braces for its most challenging season. Winter brings a surge in respiratory illnesses, exacerbates chronic conditions, and increases the risk of accidents. The result? Backlogged A&E departments; longer hospital stays and stretched resources across the system.
The Scale of the Challenge
Respiratory diseases are a major contributor to winter pressures, with emergency admissions doubling during the colder months. Chronic conditions such as asthma, COPD, and heart disease become more complex, resulting in longer emergency visits. At the same time, systemic issues like delayed discharges and transport blockages worsen the crisis. On average, nearly 12,000 beds are occupied by patients medically fit for discharge, accounting for one in eight adult general and acute beds.
Bed occupancy has exceeded the NHS safe threshold of 92%, continuing a 15-year upward trend. Ambulance handover delays have reached record highs, and some patients have waited more than two days for treatment in A&E. These challenges are compounded by staff shortages, with around 53,000 NHS staff absences recorded weekly in January 2025.
Building resilience
To build resilience against winter pressures, NHS Trusts must therefore coordinate planning across transport, discharge and community care. NHS organisations can leverage national framework agreements that provide structured, compliant routes to essential services:
Non-emergency patient transport delivers over 11 million journeys annually at a cost of around £500 million. Its effectiveness is critical to NHS winter resilience as, when demand peaks and capacity is stretched, even marginal inefficiencies can have a knock-on negative effect across the entire health system. Our framework agreement helps trusts commission a range of transport services, from wheelchair-accessible vehicles to secure mental health transport. By integrating these services into care pathways, trusts can avoid missed appointments and expedite timely discharges.
Designed to facilitate hospital-to-home transfers, this framework agreement supports discharge-to-assess models, combined home care, and step-down beds for mental health patients. These services free up hospital capacity and reduce delays for medically stable patients. It helps to release hospital capacity and reduce delays for patients who are medically stable enough to be discharged, but who require ongoing support.
The annual cost of asthma and COPD on the NHS is estimated as £3 billion and £1.9 billion respectively. In total, all lung conditions (including lung cancer) directly cost the NHS in the UK £11 billion annually. Our framework agreement offers innovative respiratory products and services, including remote monitoring technology to enable long-term observation and self-management of conditions, reducing unnecessary hospital admissions and easing pressure on A&E. Rapid ordering and dispatch ensure patients receive equipment and consumables promptly, supporting care in the community and aligning with the NHS Long Term Plan.
Utilising framework agreements
With commentators already predicting “winter chaos“, NHS SBS is helping trusts to prepare early. Winter pressures cannot be avoided, but their impact on patients can. By adopting strategic procurement via NHS SBS framework agreements, NHS organisations can ensure patient flow through the system, improve clinical outcomes, and ease the squeeze on health services this winter.
Using framework agreements, NHS organisations can connect operational decisions to broader goals; delivering enhanced patient pathways, reducing pressure on urgent services, and facilitating care closer to home. Acting as a mediator and support for both parties, an additional resource for any queries, questions or challenges, the framework agreement lead is always ready and willing to support and facilitate, an additional helpful resource.
