The Winter Pressures Paradox: Strengthening Primary Care in the Coldest Months

• 1st December 2023

Getting your Trinity Audio player ready...

Table of Contents

Updated: January 2026

Winter pressures in the NHS describe the predictable rise in healthcare demand during colder months, driven by respiratory illness, flu, RSV, worsening long-term conditions and workforce strain, which places immediate pressure on primary care. These winter pressures are felt first through increased same-day demand, medicines queries and capacity constraints. Proactive workforce planning and demand monitoring help primary care reduce avoidable escalation and maintain safe access during peak winter months.

Key Takeaways:

• Prioritise early planning: Prepare for winter pressures by identifying demand drivers and pressure points before peaks hit primary care.
• Track what matters weekly: Monitor appointment demand, workforce capacity, respiratory illness trends and medicines workload to spot escalation early.
• Implement workload redistribution: Use the full primary care team effectively to protect GP capacity and maintain safe access during winter pressures.

1. What are winter pressures in the NHS
2. Why winter pressures hit primary care first
3. What is different with winter pressures in 2025/26 and into 2026
4. Practical actions primary care can take now to manage winter pressures
5. Medicines Optimisation actions that reduce winter demand
6. How Core Prescribing Solutions can support during winter pressures

What are winter pressures in the NHS?

Winter pressures in the NHS refer to the predictable increase in demand for healthcare services during the colder months, which stretches capacity across primary care, community services and hospitals, often at the same time as workforce availability is reduced.

Key drivers of winter pressures include:

• Respiratory illness: seasonal rises in flu, RSV, COVID-19 and other respiratory infections increase consultations, prescribing and admissions.
• Frailty and long-term conditions: colder weather exacerbates chronic conditions, leading to more frequent GP contact and clinical intervention.
• Delayed discharge and flow issues: pressure in hospitals limits discharge capacity, creating knock-on effects for community and primary care services.
• Workforce absence: higher staff sickness and annual leave reduce available capacity when demand is highest.
• Access demand: increased same-day appointments, urgent queries and medicines-related requests place immediate strain on primary care systems.

This combination creates sustained pressure that primary care often feels first and most acutely during winter months.

.

Why winter pressures hit primary care first

Winter pressures tend to affect primary care before other parts of the NHS because it is the first point of contact for most patients when symptoms worsen or new health concerns arise.

In practice, this is seen through:

Frailty escalation: older and vulnerable patients deteriorate more quickly in cold weather, leading to complex reviews and coordination with community services.

Spikes in same-day demand: more urgent appointment requests for respiratory symptoms, infections and acute deterioration.

Increased respiratory reviews: higher volumes of flu, RSV, COVID-19 and asthma or COPD exacerbations requiring timely assessment.

Rising medicines queries: repeat prescription requests, supply issues and medication-related concerns increase during winter.

What is different with winter pressures in 2025/26 and into 2026

Winter pressures in 2025/26 and into 2026 are shaped by a stronger NHS focus on prevention, flow and early intervention rather than short-term winter fixes, with greater emphasis on managing demand in primary care to protect urgent and emergency care.

This includes sustained respiratory vaccination programmes, clearer expectations around same-day access and alternatives to A and E, increased use of data to predict surges, and closer coordination across primary care, community services and hospitals. The direction of travel is towards planning earlier, using workforce and demand data more intelligently, and reducing avoidable escalation before pressure reaches crisis point during winter.

Practical actions primary care can take now to manage winter pressures

Primary care can reduce the impact of winter pressures by putting practical, operational measures in place ahead of peak demand rather than reacting once services are already stretched.

Key actions include:

Track demand and capacity regularly: monitor appointment demand, workforce availability and pressure points weekly to identify escalation early.

Strengthen triage processes: ensure consistent same-day triage to direct patients to the right clinician or service first time.

Use clear respiratory pathways: standardise assessment and follow-up for flu, RSV, COVID-19 and long-term respiratory conditions to avoid duplication and delays.

Optimise vaccination workflows: streamline flu, COVID-19 and RSV delivery to maximise uptake and reduce avoidable winter illness.

Redistribute workload safely: deploy the wider primary care team effectively to protect GP capacity while maintaining appropriate governance.

Medicines Optimisation actions that reduce winter demand

Medicines optimisation can play a key role in reducing winter pressures by preventing avoidable harm, reducing follow-up demand and supporting safer, more efficient use of primary care capacity.

Governance-led actions that help include:

• High-risk medicines checks: prioritising structured reviews of medicines associated with hospital admission risk during winter, such as those linked to falls, dehydration or respiratory compromise.
• Targeted structured medication reviews: focusing reviews where they are most likely to reduce escalation, for example in frail patients or those with multiple long-term conditions.
• Safe repeat prescribing processes: strengthening repeat prescribing governance, authorisation and monitoring to reduce errors, urgent queries and last-minute requests.
• Proactive medicines queries management: addressing common seasonal medicines issues early to avoid repeated contacts and urgent interventions.

How Core Prescribing Solutions can support during winter pressures

Core Prescribing Solutions supports primary care by helping practices plan ahead for winter pressures, deploy workforce support safely and strengthen medicines processes where demand is highest.

Through practical workforce planning, governance-led medicines optimisation and flexible support models, we work alongside teams to reduce avoidable pressure, protect capacity and support safe patient access during the winter months.