Community Network

Winter pressure wards in north west London

woman in a wheelchair with a cup of tea

25 / 11 / 2014


Central London Community Healthcare (CLCH) has designed a new model of care to align community-based winter pressure wards with GP practices.

What the organisation did and why

For winter 2014/15, community-based winter pressure wards provided by Central London Community Healthcare (CLCH) will be aligned with GP practices, rather than acute hospitals. 

At just six weeks' notice, winter pressure wards in 2013/14 added extra capacity aligned to the hospital, but did not improve the model of care. CLCH sought to develop a new model of care, moving away from the short period relief (six to eight weeks) model covered by winter pressures money, partly driven by ongoing pressure on the acute sector. 

The new model aligns community-based winter pressure wards with GP practices.

  • Community services built a partnership with primary care, to understand what specification will work, and develop clear agreements.
  • District nurses were up-skilled to ensure good handovers.
  • A whole ward accountability structure was created, with a lead GP practice. This was costly on a one-off basis and the community provider had to lead.
  • The model ensured that links to the local acute provider were maintained to retain specialist cover.

Results and benefits

The links to general practice mean that patients retain a link to their own GP.

Overcoming obstacles

One of the major challenges was consistency across communication, clinical governance and approaches to safety.

Next steps

It is an evolving model, which will branch out to include a broader spectrum of care, including partnership with nursing homes.

Want to know more? 

Please email Dr Joanne Medhurst, medical director, CLCH:

The case study is taken from Working better together: community health and primary care.

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