NHS Providers has said that NHS trusts are exploring all avenues to support patients and staff as the NHS heads into what trust leaders believe will be the ‘most difficult winter in the history of the health service’.

The organisation’s regular annual survey of trust leaders shows a much higher level of concern about the coming winter than ever before. It is calling for immediate, emergency action to support social care.

Trust leaders are deeply concerned about the combined impact of increased demand for emergency care, growing waiting lists, significant and sustained staff shortages, potential staff burnout, the extra resource needed for vital vaccination campaigns and the prospect of high levels of coronavirus, flu and other respiratory viruses.

While coronavirus cases are well below their January 2021 peak, trusts are ‘beyond full stretch’ as they deal with current pressures and prepare for winter by expanding capacity, recruiting more staff, increasing collaboration with partners across health and social care and delivering vaccinations.

NHS Providers' State of the provider sector report hows that trust leaders are particularly concerned about the scale of pressure they are already under before the NHS has reached its traditional peak of winter demand which usually runs from mid-November to end-February, with pressure often greatest in January.

Chris Hopson, chief executive of NHS Providers, said: "The message from trust leaders is loud and clear: judging by the pressure the NHS is currently under, the service is heading for the most difficult winter in its history. The current Covid-19 caseload is considerably lower than the peak at the start of the year, but when we consistently run our health and care system at the limit of its capacity, it doesn't take much extra pressure to increase risk to patient safety and quality of care.

"The loss of bed capacity due to Covid-19 infection control; the current level of NHS staff shortages and pressure on existing staff; the resource needed for the vaccination campaigns; the 7,000 Covid-19 patients in hospital; and the recent increase in social care workforce shortages are all combining to bring major, additional, pressures.

"But trust leaders are equally clear that it is their responsibility to support their staff to provide the best possible care to all patients who need it, as rapidly and effectively as possible. That's why they are working so hard to prepare for winter and deliver vaccinations as fast as they possibly can.”