Winter pressures For social care providers, this
restructuring raises immediate concerns: n Who will be making funding decisions at a local level this winter?
n How will accountability for hospital discharge targets and winter resilience be managed?
n Will leadership turnover lead to delays in decision-making just when speed is most crucial?
Key winter challenges ahead 1. Cuts and funding gaps The requirement for ICBs to halve running costs and for trusts to return to pre- pandemic corporate budgets inevitably means resources will be diverted away from administrative capacity. While some of this aligns with the NHS’s need for ‘fewer checkers and more doers’, there is a risk that these cuts will weaken coordination with external partners, including social care providers. For local authorities, the situation
is similarly bleak. Many councils face continued financial pressures across all departments, compounded by rising demand for care services. Winter has always been a flashpoint, but this year funding gaps could become chasms.
2. Employment and workforce pressures With 50 per cent headcount reductions planned across NHS England and DHSC, there will be fewer people to coordinate discharge processes, manage winter escalation plans, and liaise with care homes. Meanwhile, social care providers are
grappling with their own workforce challenges: n Recruitment remains difficult in a competitive labour market.
n Sickness absence often spikes during the colder months.
n Rising costs of living put pressure on wage expectations, while funding for fee uplifts remains inconsistent.
n The combination of NHS and social care workforce pressures creates a dangerous cocktail for winter.
3. Rising demand and seasonal pressures Winter demand is not a new phenomenon, but its intensity seems to increase year on year. Factors include: n Flu and COVID-19: seasonal infections lead to spikes in hospital admissions and higher staff sickness rates.
n Delayed discharges: a lack of capacity in social care can lead to patients being stuck
Winter has always been a flashpoint
in hospital beds, creating backlogs across the entire system.
n Public expectations: families expect high- quality care and rapid access to services, even as resources dwindle.
4. Risks beyond winter: systemic challenges Beyond the seasonal spike, the restructuring adds further risks: n Leadership turnover: new structures often bring leadership churn, with interim appointments and delayed decision-making.
n Staff morale: uncertainty over job cuts in the NHS affects relationships and collaborative efforts.
n Care disruption: funding and planning delays risk undermining service continuity.
n Transition complexity: the handover of responsibilities from NHS England to DHSC and potentially regional bodies may not align neatly with the demands of winter.
Without significant preparation and coordination, the winter months risk becoming a perfect storm for both the NHS and social care providers. One of the most significant risks is
that NHS and local authority leaders, understandably focused on restructuring, become inward facing. While leadership teams focus on internal reorganisation, winter will arrive with its usual pressures – plus the additional strain of systemic upheaval. This creates a paradox – just when
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www.thecarehomeenvironment.com October 2025
the system needs the most outward collaboration, energy is being consumed by inward restructuring. But, as they say, with every challenge comes opportunity. So how can social care step up and grab the opportunities on offer?
A proactive approach Despite the turbulence, there is opportunity here for social care providers to play a proactive and transformative role.
1. Hospital discharge partnerships Hospital discharges have long been a sticking point during winter. Delayed transfers of care lead to bed blocking, longer hospital waits, and worse outcomes for patients. When beds are occupied by patients
who no longer need acute hospital care but cannot safely return home, emergency departments back up. Evidence shows that every extra day in hospital increases the risk of infection, muscle loss, and loss of independence for older or frailer patients. We know that the primary reason for delayed transfers of care (DToCs) is that support packages are not ready outside hospital. With NHS staff stretched thin due to
redundancies and budget cuts, social care providers have an opportunity to position themselves as part of the solution. The underlying issue is that hospital,
community health, and social care services operate in silos. Delayed discharges are not simply a failure of one part of the system; they are a failure of coordination. Hospitals
ValentinValkov -
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