Winter Update - November 2025

Meeting: Public Board

Date: 5 November 2025

Report Title: Winter Update 2025

Agenda Item: PUB25/11/5.2

Author: Lucy Goddard, Interim Business Support Manager. Claire Creek, Senior Executive Support Manager.

Lead Director: Darren Meads, Chief Operating Officer

Purpose: Information / Noting

Assurance: Reasonable

Link to CQC domain:

• Caring
• Responsive
• Effective
• Well-led
• Safe

Link to EEAST Strategic Mission:

• Patient Mission
• Partnership Mission
• People Mission
• Productivity Mission

Link to Strategic Risk:

• SR1 Demand and Capacity
• SR6 System Partnership
• SR8 Staff Retention
• SR9 Organisational Development
• SR10 Corporate Efficiency Programme (CEP25)

Equality Impact Assessment: YES – Completed and included in winter plan

Previously considered by: Private Trust Board: EEAST Winter Plan 10 September 2025.

Purpose: The purpose of this report is to outline on the preparedness actions EEAST is taking for winter 2025.

Recommendation: For information and noting.

Executive Summary:

Demand, Capacity and Hospital Handovers (September 2025)

Introduction / Background:

This report updates on the progress of the winter actions EEAST is taking in preparation for winter 2025. It is supported by the EEAST Winter Plan which outlines the specific risks during this time.

Winter provides some additional challenges to the NHS, including the increased use of the 999 system, extended hospital handover delays and viral infection increase affecting health care use and potential staff sickness.

In response to this, EEAST has distilled updates from

Winter Planning Updates

October 2025 Update

Increase call handler and clinical advice service establishment levels

Recruitment with call handlers has increased during September with an increase in the course fill rate (usually c.60%) up to around 85%. With pipeline considered, the target of 245 is planned to be reached.

Clinical Advice Service staff recruitment is continuing well. 107 staff are in post and with the additional band 7 Navigators included, the figure is 134 clinicians based in the EOCs.

Handover 45 (HO45) including the Release to Respond protocol Handover 45 is a national aim to ensure that ambulance handovers do not exceed 45 minutes anywhere in England. Where this does occur, the handover 45 protocol outlines the required escalation processes. NHS England Regional Urgent and Emergency Care Team have agreed to undertake a review of this protocol to ensure its effectivity for the winter period.

The release to respond protocol is an agreement between all hospitals and the ambulance service to immediately release a waiting ambulance should a patient in the community who is in critical need call 999. This protocol will remain in place for the duration of winter.

Establishing Local Operational Oversight Cells (LOOC) The Local Operational Oversight Cells are teams of specialist operational ambulance leaders who maintain links directly with local hospitals and regional NHSE coordination teams to undertake escalation on barriers to responding to patients. This team supports the priorities of the Trust’s Tactical Operations Centre (TOC) who support wider Trust functions.

All operational areas are planned for early November, except SNEE who will plan to mobilise late November.

Alternative Care Pathways & ED Conveyance Reduction EEAST has the lowest levels of conveyance rates recorded suggesting that efforts to avoid patients being unnecessary being conveyed to hospital are being taken.

Where community pathways exist, EEAST is working alongside the ICBs to refer patients into these. In partnership with two acutes, EEAST is supporting a potential trial for patients in care homes to reduce the need for treatments in hospitals.

Annual Leave & Training Reductions For December and early January, annual leave levels are reduced, and training abstractions are limited to 50% of the usual levels to ensure that more ambulance staff are available at peak times.

Operational (A&E and EOC) productivity measures EEAST has taken steps to improve its productivity when compared to other ambulance services. Broadly, productivity targets are on track, and the overall position is on plan. This has provided the equivalent of around 450 additional staff to the service. These improvements include an increase in the number of patients per hour that are assisted through telephone support.

Staff Welfare These bespoke vehicles are designed to provide refreshments and support to staff during protracted incidents such as hospital handover delays. They have been found to be an important asset in support staff during extreme periods of pressure. The plan is to use these resources again this winter and the rotas and locations of these vehicles are being finalised.

Flu Vaccinations The number of clinical staff that receive vaccination against influenza helps to maintain staffing levels during the winter period. As of 14.10.25 18% of frontline staff (1,289) have received the vaccination, an increase of 4% when compared to the same point last year. EEAST has set a target of 2,444 to receive the vaccination.

Key Issues / Risks:

Currently EEAST is observing more risk than initially expected in some areas of the region. This can directly affect EEAST’s response times. These risks include:

• Higher than planned hospital handover delays, with some extensive levels reported at certain hospital sites.
• An increase in sickness absence rates in some operational areas of the Trust.

Options:

None, this report is for information only.

How does this report link with EEAST’s vision, purpose and values?

The winter plan is specifically designed to support all four Trust missions (patients, staff, partnerships and productivity).

Summary:

These updates summarise the current priorities for winter preparedness from the East of England Ambulance Service.