We have all been there, 2am on a freezing January night. A baby with bronchiolitis is struggling to breathe, her parents desperate for help. The emergency department is full, staff are working flat out, and still the wait feels endless. For families like hers, this is winter in the NHS.
Every year winter feels like a runaway train hurtling towards us. For children and young people’s services, it brings an all too familiar pattern: packed waiting rooms, wards stretched to capacity, and staff doing everything they can to meet demand. But behind the numbers and headlines are real children, families and teams — and they deserve more than crisis management.
Children are essentially 25% of our present but 100% of our future. Yet too often, when winter planning is discussed, it can feel that their needs are overshadowed by adult services. The reality is predictable: bronchiolitis, asthma, flu, gas and sepsis all surge at the same time, while families already facing poverty or poor housing are hit hardest.
And then there’s the workforce. Winter isn’t just about viruses — it’s about people. Sickness absence, rota gaps and sheer exhaustion mean children’s nurses and paediatric teams are under relentless pressure. Many of us know the feeling of starting a shift already on the back foot. Too often, despite the best efforts of all those across the board, they become 'normal'.
So how do we prepare differently this year?
- Refresh the basics. Clear pathways for bronchiolitis, asthma and sepsis, kit checked and ready, and staff confident in escalation.
- Look after staff. Breaks, safe rotas and visible leadership aren’t luxuries — they’re what keeps teams safe and able to deliver care.
- Work as a system. Paediatrics needs a seat at the table in every trust’s winter plan, not as an afterthought but as a core service.
- Support families. Vaccination, handwashing and strong safety netting advice of “when to seek help” that empower parents but so does recognising the reality of fuel poverty and making sure families know where to turn for wider support. Community based services such as health visitors, which are often undervalued.
Children’s nurses have always spoken up for those who can’t. This winter, that advocacy is more important than ever. Preparing for winter isn’t just about managing numbers — it’s about protecting childhood, reducing harm, and giving families confidence that the NHS is there when they need it.
The challenges are real, but so is our commitment. With the right focus and the right support, we can face this winter together — and ensure that children and young people aren’t left behind.
