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Winning in winter with marginal gains: enhancing welfare on the frontline

Winter pressures on the NHS challenge every one of us. Patients may experience delays waiting for emergency ambulances and face extended waiting times at hospital emergency departments (ED). During this season, GPs, hospitals, NHS organisations and staff will face increased demand for services; yet are still required to deliver on agreed performance targets with only a finite availability of resources. Add Brexit and the second wave of COVID-19 wave into the mix and it might appear difficult to make improvements in any of these areas. During the winter of 2019–2020, a large ambulance service in England introduced a ‘welfare van’ to support busy emergency ambulance crews in one of its busy urban areas. It was tasked to see if it could make a positive difference to staff welfare and uphold or improve on ambulance service performance during a period of expected increased demand.