NHS England has published a letter setting out the national approach to winter 2026/27, spelling out the actions every part of the NHS — and local government — needs to take to prepare.
Two dates matter most for practices. Draft winter plans have to be completed by the end of August 2026, and those plans will then be tested at NHS England’s regional stress test exercises in September 2026, against surge and extreme surge scenarios.
ICBs are responsible for the winter plan for their area. It has to be built on a whole-area demand and capacity analysis with robust planning assumptions, and it has to demonstrate sufficient commissioned capacity across the system.
For primary care, that means winter plans need to cover:
- Same day urgent appointments
- Enhanced access
- NHS 111 direct booking
- Community pharmacy
- Out-of-hours provision, including during holidays and over Christmas
- Delivery of the seasonal vaccination campaigns
For GP partners and practice managers, the practical implication is timing. ICBs have only a few weeks to gather this evidence before the end-August deadline, so practices and PCNs are likely to be asked for capacity data well before then, not after it.
If your practice hasn’t yet reviewed its enhanced access rota, NHS 111 booking capacity, vaccination clinic schedule or out-of-hours cover for the Christmas period, now is the time — before the regional stress tests in September put those plans to the test.
As winter pressures continue to test the whole system, practices that go into the planning process with their own numbers already in order will be in a much stronger position when ICBs come asking.
Why this matters for your CQC readiness
There’s a shortcut hiding in this: the evidence ICBs will be chasing for winter plans is largely the same evidence CQC assessors ask for.
Same day access, enhanced access rotas, out-of-hours cover and vaccination clinic schedules all sit inside Safe & effective staffing and Safe environments. Whole-area demand and capacity analysis is Governance, management & sustainability in all but name. And infection control considerations for winter (flu, RSV, respiratory illness surges) map straight onto IPC. These four statements — staffing, environments, governance, IPC — are consistently where practices lose marks under the Single Assessment Framework, even when the quality of care itself is fine. The gap is rarely the care; it’s the proof.
That’s the whole premise of the Harmony CQC method: Risk → Process → Training → Proof. If you’re pulling together winter capacity data for your ICB anyway, you’re already doing Step 1 of the Simple Path — collating the work. The Skills Matrix will show you at a glance whether your team has the cover to deliver enhanced access and out-of-hours over Christmas, and the Risk Register turns any gaps you find (a thin out-of-hours rota, an under-resourced vaccination clinic) into a prioritised, dated action list — the same list a CQC assessor would want to see you already working from.
Practices that go into September’s regional stress tests with their winter numbers in order won’t just be better prepared for the ICB. They’ll be sitting on a live evidence trail for Safe and Well-Led — no extra work, just the same groundwork pointed at two audiences at once.
Want a hand turning your winter planning data into CQC-ready evidence? Take a look at our Inspection Readiness Workshop at workshop.hcqc.co.uk, or join the free community at 1.hcqc.co.uk.