Winter is coming We expect this winter that more people will call on the NHS for help than ever before. Like partner organisations across the country, we have been preparing in advance to ensure no patient is needlessly waiting for help from the ambulance service. Much like the rest of the NHS, the winter months are significantly challenging for us because of increased calls to 999 and 111; other factors such as increased sickness, demand on acute hospitals and reduced services in the wider health service, can affect our ability to respond to patients quickly. Comprehensive staffing, resourcing and management arrangements will be in place for all areas of the trust. Our local managers will be engaging with clinical commissioning groups over the next few weeks to review contingencies and ensure we are working together effectively throughout winter. Everyone, including the public and partner organisations, has a role to play in ensuring we are able to respond to people in need of urgent and emergency care. Commissioners can play a key role in helping local people better understand what can realistically be provided by ambulance services and in what timeframe, especially for less urgent calls. 111 and 999 can work seamlessly to manage access to urgent and emergency care services. But these services need to be responsive, timely and available to refer onto 24/7 in order to reduce emergency department attendances and hospital admissions. Our operational plans are supported by communications plans which aim to make people aware of the actions they can take to stay well, promote alternatives to 999 and raise awareness of the steps we are taking to reduce seasonal demand. This will echo the format and messaging of the national Stay Well This Winter campaign where appropriate for the ambulance service. We will also support local partners to deliver their winter communications plans.