Top A&E doctors warn of rising pressure from winter viruses

Frontline doctors are warning winter virus cases are "creeping up" alongside pressure on emergency departments, with new NHS data showing the number of flu patients in hospital is up more than half in a week.

Today's figures show an average of 234 people were in hospital with flu every day last week, up 53% on the week before.

Hospital norovirus cases continue to rise, with hospital cases up 15% on the previous week to an average 406 people each day - a 28% increase on the same week last year. An average of 92 beds were closed each day last week and unable to be used due to measures to stop the spread of norovirus to other patients.

RSV cases are also increasing, with data showing in the week to 3 December that an average of 146 children were in hospital each day with the virus, up 11% on both last year and the previous week (131).

Despite these pressures, today's data shows the steps taken by NHS staff to prepare ahead of winter are paying off.

The NHS started planning for winter earlier than ever before, including the nationwide rollout of care ‘traffic control’ centres, extra ambulances and beds, and the rapid expansion of the world-leading virtual wards programme, helping keep patients out of hospitals and treating more people at home and in the community.

There were 358,797 calls answered by the NHS 111 service last week - 14% more than the 315,788 in the same week last year - but despite the increase in calls, thanks to measures to boost resilience and grow the number of call handlers, more than twice the proportion of calls answered last week were answered within a minute (from 32% to 69%).

As a result of robust winter planning there are more beds available, with an average of 100,903 general and acute beds open each day, up almost 1,400 from 99,508 last year. There are currently 1,200 more patients in hospital compared to the same week last year – with 90,341 adult beds occupied last week, up from 89,125 the year before.

Challenges discharging patients who no longer need to be in hospital settings are still having a considerable impact, with the number of people fit to be discharged to places such as care homes but remaining in hospital up to 12,883 each day, from 12,654 the week before.

Staff absences are increasing, with an average of 800 more staff off each day last week compared to the previous week - an average of 47,018 staff off each day (from 46,201).

The data comes as the NHS prepares for further industrial action this winter, with junior doctors staging the longest consecutive strike in NHS history during one of the most challenging periods of the year.

Announced this week, there will be a three-day walkout from 7am on Wednesday December 23, followed by a six-day strike from 7am on Wednesday 3 January .

Professor Julian Redhead, NHS England’s National Clinical Director for Urgent and Emergency Care, said: "This latest data will come as no surprise to those of us working on the frontline, who are seeing the number of people coming to emergency departments and patients in hospital with viruses like flu, RSV, and norovirus creeping up, and continued Covid pressure.

“The measures we set out in our urgent and emergency care recovery plan and winter preparations earlier this year are having an impact, with more than twice the number of NHS 111 calls being answered within a minute, and almost 1,400 more general and acute hospital beds open compared to the same time last year.

"Demand on hospitals and staff remains high, and as we experience more spells of cold weather and people gathering indoors for festive events and end of year celebrations, we expect to see a continued increase in winter viruses spreading in the community and in some cases, this will lead to hospital admissions.

“And now we are also preparing to mitigate the impact of the latest strikes this Christmas, once more prioritising urgent and emergency care – including emergency surgery - to protect patient safety and ensure those in life-saving emergencies can receive the best possible care. So the public can continue to play their part by using NHS services in the usual way and calling 999 in an emergency and using NHS 111 for other health conditions, and by getting their flu and Covid jabs if eligible."

The pressures are being felt across the country, with other frontline staff reporting increases in demand and viruses on the rise in their communities.

Richard Jennings, group chief medical officer, St George's, Epsom and St Helier University Hospitals and Health Group, said: “Our three emergency departments are responding to very high demand at a time when our hospitals are very full, and in particular we are seeing an increase in people coming to our emergency departments with norovirus and flu – both of which can make vulnerable people very poorly.

“After very high summer attendances in our emergency departments, hospitals have remained extremely busy with sick people needing our care.

“So - while all our doctors, nurses and other colleagues work hard to get everyone well again and discharged home - you can support your local NHS by getting vaccinated against flu and covid and, if you need health care advice when it’s less urgent, please use NHS 111 online.”

Dr Peter Williams, Medical Director, Mersey and West Lancashire Teaching Hospitals NHS Trust:  “As with all other hospitals across the country, we are experiencing extremely high demand for our emergency care services, and with the recent cold spell, there is significant pressure on A&E departments.

"Infection rates in the local community for illnesses such as diarrhoea and vomiting are on the rise, with winter respiratory viruses including flu and Covid infections also remaining prevalent.

“Inevitably, the increase in people seeking healthcare puts pressure on our hospitals and causes delays for those attending or requiring admission through Emergency Departments. We ask anyone who feels they need urgent care to consider the best service for their needs - local Urgent Treatment Centres have expert clinicians that can treat a range of conditions, and local pharmacies are open seven days a week to offer advice and over the counter medications. Please only use A&E if it is a serious or life-threatening emergency.”

Dom Hardy, Chief Operating Officer, for Royal Berkshire NHS Foundation Trust said: “Our Emergency Department has been seeing unprecedented levels of demand with our records for attendances having been broken multiple times over the past year.

“As a trust, we continue to do everything we can to improve our services and provide high quality care for patients who need our help – including improving triage services, extending our same-day emergency care, and opening a new older people’s space in our Emergency Department.

“However, we know up to half of patients currently attending our Emergency Department could instead consider using other NHS services such as NHS 111, Urgent Care Centre or self-care at home - our clinicians’ priority is always providing high quality care to everyone; but we can all play a part in supporting our local NHS by getting vaccinated, and using NHS 111 online.”

The weekly situation report publications can be found here: Statistics » Urgent and Emergency Care Daily Situation Reports 2023-24