NHS England tells health services to accelerate winter preparations

NHS England has instructed integrated care boards (ICBs), NHS trusts, ambulance services, primary care networks and local authorities to begin preparations for winter 2026/27 immediately, setting out a series of national expectations aimed at improving resilience ahead of the colder months.

In guidance published on 17 July, NHS England said every local area must produce a robust, clinically led winter plan by the end of August, developed jointly with partners across acute care, ambulance services, community services, mental health, primary care, adult social care and the voluntary sector. Each organisation must also appoint a named executive responsible for winter preparedness and response.

The plans will be tested during regional stress-testing exercises in September before being signed off by organisational boards and submitted to NHS England by 30 September.

For integrated care boards, the guidance places particular emphasis on increasing vaccination uptake, strengthening same-day access to primary care, expanding urgent community response services, ensuring sufficient social care and intermediate care capacity, and maintaining effective infection prevention and control measures across care homes and the wider care sector.

NHS trusts have been instructed to complete organisational winter plans by the end of August, prepare staff flu vaccination programmes, implement emergency department and discharge pathway improvements, and continue efforts to eliminate corridor care while protecting elective services throughout the winter period.

Ambulance services are expected to continue improving Category 2 response times, increase the use of telephone and on-scene clinical management to reduce unnecessary hospital conveyances, and work with hospitals to achieve 15-minute ambulance handovers, with none exceeding 45 minutes.

In its letter to NHS leaders, NHS England said last winter delivered the best four-hour emergency department performance and ambulance response times in three years despite an early flu season, a January norovirus peak and periods of industrial action. It said early planning and close collaboration across health and social care had been central to that improvement and should begin again immediately for winter 2026/27.

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