Winter Resilience: NHS England South


In the winter of 17/18, the south region required support for 35 Acute Trusts that were experiencing operational pressures. The south was at this time a pilot area for blended NHSE and NHSI delivery teams, who were already stretched in their capacity to support National Winter Operations Team calls and requests. In collaboration with SCW CSU, Clarity were approached to support both SE and SW winter teams, with a view to driving improvements in A&E performance.

Clarity was invited to review the existing CIP programme, and then develop a robust governance process to drive initiation, delivery and assurance. We were also invited to analyse the capability of the existing PMO and make recommendations to create a trust-wide service improvement team.


Supporting 18 trusts in the south east and 17 in the south west, we assembled a flexible multi-disciplinary team, comprising a senior lead, senior manager, middle management, and project support. Early in the process we conducted a thorough review and extensive overhaul of tasks and procedures.

We monitored points of pressure and concern, relaying these to regional and national operational leadership. We prepared regular briefs for the National Winter Director, papers for weekly operational looking-forward meetings, end-of day reports for operational leadership, rota management, and were instrumental in daily winter resilience planning. We provided greater depth of data analysis than was previously available, and co-developed improvement strategies for individual Acute Trusts and Regional priorities.


  • The SW and SE regions placed first and second for Acute A&E performance for most of the winter, a marked improvement on previous years.

  • The model received national and regional approval, and the client looked to further build on our approach for future years to consistently create, develop and deliver sustainable CIP.

  • In establishing effective relationships across all areas, we became trusted team members and were invited to join Regional Senior Management Teams.

  • This approach released capacity for regional delivery teams to focus on front-line service support.


“The Clarity team came in at a late stage to assist NHS England South in managing the Winter Operations functions for both the South East and South West regions from December 2017 through into April 2018. The situation was further complicated by ‘vanguard’ work being undertaken to integrate working across NHS England and NHS Improvement delivery teams in support of the 35 Acute Trusts in the region.


The positive and proactive approach from the Clarity team, coupled with their professional and flexible attitudes, resulted in an impressive outcome, with south west and south east occupying the performance top spots in the country on the vast majority of days throughout winter 2017/18. Indeed, the skills, experience and support provided by all Clarity personnel were significant factors in ensuring that the pressures faced in one of the most challenging winter periods for the NHS were managed successfully.


I would have no hesitation in recommending Clarity as a consultancy that actually supports and enhances the extant teams, making valued contributions towards delivery and not just formulating plans and handing them over to NHS staff to implement.”

Andy Wapling - Regional Head of Emergency Preparedness, Resilience and Response, NHS England (South)