The impact of Covid, an expected resurgence of flu cases, staff shortages and escalating demands are expected to create the perfect storm to exacerbate the difficult pressures already facing health services in the county.
A new report looking at the preparations being made for winter is due to be discussed by the county's joint health overview and scrutiny committee when it meets on Monday.
In the report, Shropshire and Telford & Wrekin Clinical Commissioning Group's planning director Sam Tilley writes that this winter will see 'an unprecedented set of challenges'.
A high demand on A&E services at Shropshire's acute hospitals is already posing problems ahead of the winter months, with significant delays seen by ambulances handing over patients to the county's emergency departments.
Figures in the latest report to the board of directors at Shrewsbury and Telford Hospital NHS Trust, which runs Royal Shrewsbury Hospital and Telford's Princess Royal Hospital, show that there were 863 occasions where ambulances waited more than an hour to handover patients in September.
Today, the Care Quality Commission has published its latest findings into inspections at the hospitals and has revealed some improvements have been made, although the trust remains 'inadequate' and in special measures.
The report by Ms Tilley outlines the work being carried out to prepare for winter and respond to the demand on emergency services.
She says: "It is important to note that this year we are facing a unique set of challenges across health and social care and the Shropshire, Telford and Wrekin system is no exception.
"This includes a set of distinct but interdependent issues including: The ongoing impact of Covid-19, the expected resurgence of other infectious diseases, the ongoing recovery of services, significant workforce capacity pressures and an already emergent increase in demand on all services."
She says the CCG has funded additional same day capacity in primary care which will result in over 22,000 additional GP and allied health professional appointments between October and March.
Recruitment is also under way to ensure a two hour response service will be available across the whole county to all patients requiring urgent care.
The report says that health bosses are committed to doing all they can to reduce ambulance handover delays and a number of schemes are ongoing.
It says: "We are keen to continue to increase the utilisation of 111 bookable appointments and we are working with West Midlands Ambulance Service to increase the numbers of patients booked directly into appointments in A&E, urgent treatment centres, minor injury units and primary care via this route.
"Locally, utilisation of NHS 111 bookable appointment has been lower that we would like and we are working with WMAS to understand the reasons for this and to develop mitigations."
A number of specific schemes will run over the winter period to support the discharge of patients, including additional beds in the community.
There will also be a focus on avoiding unnecessary hospital admissions where possible.
Meanwhile, health chiefs are encouraging people to make sure they take up the offer of a Covid and flu jab if they are eligible.