EXTRA beds, more specialist staff in hospitals and the community, and a campaign urging people to use the NHS wisely are all part of a plan that Gwent health bosses hope will help avert a winter crisis.

An additional £1.2 million is being invested by Aneurin Bevan University Health Board in a range of measures aimed at preventing problems such as long waits and inappropriate attendances in accident and emergency departments, and disruption to routine surgery.

While a winter plan for 2013/14 did not staunch demand on A&E units or prevent operations from being cancelled, it did help reduce such problems, during what remains a season of higher than average demand in hospitals.

The health board is estimating that the equivalent of 61-98 extra beds will be needed, depending on winter demand.

Up to 78 additional beds will be opened or ready to open during January-March to help deal with an estimated rise in demand, and extra emergency department staff will be drafted in from the beginning of next month and until the end of next March.

A whole extra ward - B6 (28 beds) - will open at the Royal Gwent, with 22 extra beds available at Nevill Hall Hospital, and a further 22 at various of Gwent's community hospitals. Local authorities are also set to provide up to six beds.

The remaining 20 that might be needed are being classed in the plan as 'virtual beds' the equivalent amount the health board believes can be provided with alternatives to hospital admission, such as extra staff working in the community to increase the numbers of patients who can thus be looked after in their own homes.

A key addition to the health board's armoury during the winter will be the establishment of a frail elderly unit at the Royal Gwent, to treat patients who are comprising an ever greater percentage of attendances in A&E, and who often present with a range of long term health problems that can make more complex the treatment of the illness which has triggered their hospital attendance.

More staff, such as acute physicians and advanced and emergency nurse practitioners, will be brought into medical assessment units and A&E during the winter, and there will also be extra district nursing support out-of-hours, to provide more support for patients in their own homes.

Maintaining elective surgery will be a big challenge but the health board hopes to minimise the effect at times of higher demand through strategies such as increasing the amount of day surgery carried out.

It has also launched its annual Be Winter Wise campaign to advise and support patients to keep healthy and to use only the NHS service most appropriate to their needs.

The ambulance service, councils, and the voluntary sector are all involved too, in helping support the aims of the winter plan.