Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.


Title: Sussex-Wide Winter Plan and Brighton & Hove Cold Weather Plan



Date of Meeting: 02 November 2021



Report of: Managing Director, Brighton & Hove Clinical Commissioning Group and Executive Director, Health & Adult Social Care



Contact:  Izzy Davis-Fernandez, Head of Resilience, Sussex NHS Commissioners







Wards Affected: All






Executive Summary

The purpose of this paper is to provide the Brighton and Hove Health and Wellbeing Board with an update on progress to date in relation to winter planning for 2021/22, both in terms of Sussex-wide and local planning.



Glossary of Terms




1.           Decisions, recommendations and any options


1.1        That the Board are asked to review and comment on the Sussex-Wide Winter Plan 2021-22 Update and on the Brighton & Hove Cold Weather Plan.



2.        Relevant information


2.1       The overall purpose of the Sussex-wide winter plan is to ensure that the system is able to effectively manage the capacity and demand pressures anticipated during the Winter period. The Winter planning period covers the period November 2021 to 31 March 2022. The plan should ensure that the local systems remain resilient and are able to manage demand surge effectively, maintain patient safety and support delivery of the relevant business plan objectives and locally agreed system improvements during this period.


2.2      Health and care systems typically experience increased demand pressures during the winter months due to a number of factors including:


·         Seasonal illnesses (e.g. flu, norovirus)

·         Extreme weather (e.g. falls in icy conditions)

·         Exacerbation of respiratory illnesses and a range of long term conditions due to cooler weather.


2.3       Adding to pressures in 2021/22 are Covid 19 and the need for the NHS to recover from previous waves of Covid, particularly in terms of addressing the backlog of elective procedures due to the cancellation of operations etc. when the health system was forced to concentrate resources on Covid outbreaks.


2.4       Health and care systems have been planning systemically for winter surge pressures for a number of years, and typically a key part of this process is assessing how well the previous year’s plans met demand, and using learning from this to inform the subsequent year’s planning.


2.5       Slides on the Sussex-wide winter plan and the adult social care elements of the plan are attached as appendices to this report.


2.6       All local partners routinely consider the pressures and impacts of cold weather on the city, especially on the most vulnerable. The BHCC annual Cold Weather Plan is the overarching plan for Brighton and Hove City Council and complements the Winter Plans produced by healthcare and partner agencies. The local plan supports the National Cold Weather Plan for England.


2.7       This Plan helps prevent the major avoidable effects on health during periods of cold weather in England.  The Cold Weather plan is compiled by public health with input from all BHCC Directorates.  It describes the key issues for the city, the cold weather alert system, and related work-streams and governance arrangements. 


2.8       The human body responds in several different ways when exposed to cold weather, even at temperatures which are not ‘extreme’.

Exposure to cold temperatures has a range of physiological effects including:

•increased blood pressure

•increased risk of clotting

•suppression of the immune system

•diminished capacity of the lungs to fight off infection

•increased airway constriction and mucus production in the lungs


2.9       The Plan is linked to a system of cold weather alerts – generated by the  Cold weather health watch system  developed by the Meteorological Office including the  ‘National Severe Weather Warning Service’ (NSWWS). This comprises five levels of response based on cold weather thresholds. The thresholds have been developed to trigger an alert when severe cold weather is likely to significantly affect people's health and they also take account of temperature along with other winter weather threats such as ice and snow.


2.10    Cold Weather alerts are issued if there is a high likelihood (60% or more) of a mean temperature expected to be 2C or below and/or widespread ice and heavy snow for 48 hours in the next 5 days.


Level 0

Year round planning to reduce harm from cold weather


This emphasises that year-round planning is required to build resilience and reduce the impact of cold weather. This level of alert relates to those longer-term actions that reduce the harm to health of cold weather (e.g. housing and energy efficiency measures, and long-term sustainable approaches to influence behaviour change across health and social care professionals, communities and individuals.)


Level 1

Winter preparedness and action

Level 1 is in force throughout the winter from 1 November to 31 March and covers the moderate temperatures where the greatest total burden of excess winter death and disease occur. This is because the negative health effects of cold weather start to occur at relatively moderate mean temperatures (4-8°C depending on region) and there are normally many more days at these temperatures each winter.


Level 2

Alert and readiness


Level 2 is triggered when the Met Office forecasts a 60% chance of severe winter weather, in one or more defined geographical areas within 48 hours. Severe winter weather is defined as a mean temperature of 2°C or less and/or heavy snow and widespread ice


Level 3

Severe weather action


This is triggered as soon as the weather described in Level 2 actually happens. It indicates that severe winter weather is now happening, with snow and ice, and an impact on health services is expected

A NSWWS warning is highly likely to have been issued as well


Level 4

National emergency


This is reached when cold weather is so severe and/or prolonged that its effects extend outside health and social care, and may include for example power or transport problems, or water shortages, and/or where the integrity of health and social care systems is threatened. At this level, multi-sector response at national and regional levels will be required.




2.11    The cascade process for the Cold Weather alerts  comes from the Met office to BHCC Emergency Planning & Resilience Team (24hr) who  will alert council depts. Health & Adult Social Care cascade though to their providers in Care Homes, Home Care Providers etc.( in-house, contracted and independent). The BHCC Communications team tailor’s information as needed  for both public and staff groups via the Council website and social media. The Directorates respond according to their roles – e,g. Highways, Housing etc. NHS England cascades directly to all health trusts and to the South East Coast Ambulance Trust (SECAmb).









3.      Important considerations and implications




3.1       There are no legal implications arising from the report, which is presenting a progress update and is not requiring a decision from the Board.


            Lawyer consulted: Elizabeth Culbert Date:21/10/2021




3.2         Any additional costs resulting from the Sussex-Wide Winter Plan will need to be met from within identified resources across Brighton & Hove CCG and the Council.


3.3         Winter pressures causes significant financial strain across Health & Social Care. Current budget forecasting accounts for anticipated increased demand over this period. However, budget forecasts are subject to considerable uncertainty due to the ongoing implications of covid-19.


          Finance Officer consulted: Sophie Warburton Date: 20/10/2021



3.4      Equalities:


The aims of effective collaborative winter plan arrangements are to ensure that local health and care systems are able to continue to deliver the services that have been developed to meet the needs of the local population.  Cold weather disproportionately affects our most vulnerable residents and the Sussex Wide Winter Plan seeks to ensure that resources are targeted to support those at greatest risk. Specific services will be further developed to support delivery of the Plan during the winter period and equality impact assessments will be undertaken to support the development of those specific services.



3.5     Sustainability:


The Sussex-Wide winter plan considers how best to use NHS and local authority resources across Sussex in order to cope with seasonal demand surges for health and care services. Any negative carbon impacts of these plans (e.g. through people potentially having to travel further from home to access services where local capacity is stretched) need to be considered. However this needs to be balanced against the risks to individuals of not being able to access appropriate health or care.



Supporting documents and information


            Appendix1: Sussex-wide Winter Plan slides

            Appendix 2: B&H Cold Weather Plan