England could be about to see its most difficult winter in years — and possibly ever. Record levels of flu are hitting the country’s already-overstretched healthcare service, and hospital beds are filling up fast.
In fact, 95% of public hospital beds were full on Sunday, according to figures released by the National Health Service on Thursday. The NHS provides the vast majority of England’s hospital care.
Four infectious diseases are driving demand: flu, COVID-19, a respiratory illness called RSV and norovirus, which is also known as the winter vomiting bug.
More than three times as many patients are in hospital with flu compared to this time last year, and almost twice the number have been hospitalized with norovirus.
For every day last week, hospitals saw an average of:
- 1099 patients with flu
- 1390 with COVID-19
- 756 patients with norovirus
- 142 children with RSV
“These figures are deeply worrying as they provide yet more evidence the NHS is already under considerable strain before the pressures of winter have peaked,” said NHS Confederation acute director Rory Deighton in a statement.
“We knew that the health service was running hot, with A&Es, ambulances and general practice had their busiest October on record. But it is clear that the impact from seasonal viruses such as flu and Norovirus is being felt much earlier than in previous years, with 10% more staff off sick than the same week last year.”
NHS national medical director, Professor Stephen Powis, urged eligible members of the public to get vaccinated to quell a potential “quad-demic” of winter illnesses.
Busy hospital beds strain emergency care
The stats are particularly concerning for emergency services, which have been under serious strain for the last three years.
High bed occupancy is a key driver of overcrowding in emergency rooms, because it makes it harder to move patients into wards and other hospital settings.
When ERs themselves are full, it becomes harder to relay ambulance patients to hospitals, leaving the vehicles stuck outside hospitals instead of on the road, responding to new calls.
“Pressure on ambulance services is incredibly high, with thousands more patients arriving via ambulance (up from 83,873 to 90,514), and 35,022 hours lost to handover delays, up 87% from 18,703 this time last year,” reads an official NHS England press statement.
Long delays to emergency care have become the norm in England, with 49,592 people waiting 12 hours or more to be admitted to hospital from an ER in October. This shocking situation could be causing tens of thousands of excess deaths a year, according to research from the Royal College of Emergency Physicians.
My own analysis of coroners’ reports for the Health Service Journal revealed a four-fold increase in the number of warnings issued over emergency care delays since 2021.
These “Prevention of Future Deaths” reports are sent to the heads of hospital trusts, the health service and even government ministers. Published an average of 1.7 years after a person has died, they won’t yet capture the impact of last pressures last winter.
Creating a year-round service
Health and Care Secretary Wes Streeting has pledged to “create a health service that will be there for all of us all year round,” with an upcoming 10-year health plan that’s currently inviting comments from the public.
Deighton said that plans to prevent winter pressures would need to improve social care, which is a major factor in delays to hospital discharge. Many elderly and vulnerable patients need extra support outside of hospital, even if they are medically fit to leave.
“Tackling the capacity problems in social care is going to be critical if we are going to ensure that future winters are not as difficult,” he said. “But we also hope the 10 year plan for health … will give the NHS the financial security it needs to start making the big shifts in care needed to achieve the government’s ambitions.”
On Thursday, U.K. Prime Minister Keir Starmer announced his government would end hospital backlogs and cut waiting times for elective care procedures as part of a new “Plan For Change”.
No specific goals were described for emergency care or hospital beds. But the Prime Minister insisted that fixing elective care did not mean neglecting emergency services when questioned by a journalist.
