Can the NHS cope with winter?

Ambulance Winter is the busiest time for the NHS

With news of vomiting bugs closing wards and intensive care units for children nearly full to bursting, it is clear the NHS is under the cosh.

Such developments can be alarming, but they are also to be fully expected at this time of year.

Winter pressure in the health service is nothing new.

A decade ago, hardly a winter went by without a headline about the NHS being in crisis because of operations being cancelled or A&E units being swamped.

But in recent years the health service has got much better at planning for the rise in patients that cold weather inevitably brings.

Systems have been put in place to lessen the impact of surges in demand.

Take children's intensive care for example.

This week the Paediatric Intensive Care Society warned all 29 units in the NHS were running close to capacity due to a spike in respiratory infections.

But thanks to robust preparations and planning no children suffered.

That's because services can be borrowed from adult wards, while in-built flexibility in the system allows beds to be "upgraded" with equipment to deal with the sickest children.

Such systems have been honed over many years of dealing with winter pressures.

'Less wriggle room'

It is well known cold weather causes extra deaths - over 1,000 a week on average - as heart attacks, strokes and respiratory problems rise as temperatures fall.

Hospitals also see increases in injuries relating to falls, especially among the elderly, as well as problems with bugs like norovirus.

The Department of Health in England tries to relieve the pressure by offering flu vaccinations to the most at risk groups, while local government is given money to try to help those most at risk of the cold weather.

Emergency funds are also available to the NHS to help them cope when the pressures get most acute.

Not that the recent spate of difficulties should be considered severe - yet.

Flu levels are low at the moment and, while norovirus is up on last year, that is partly down to an unusually small number of infections 12 months ago.

However, that does not mean it will be plain sailing for the NHS this winter.

Jo Webber, of the NHS Confederation, accepts that a spate of extremely cold weather could make matters worse, although she believes the NHS will cope with whatever is thrown at it.

But she says the public should expect more, pointing out if there were better and more accessible services available in the community hospitals would not be put under so much strain.

"We shouldn't be asking the NHS to "cope" with winter, fighting to stay on top of pressures," she adds.

While the health service is better prepared than it used to be, there is less wriggle room than ever.

Over the last 10 years the number of beds has been falling, leaving hospitals operating close to capacity for much of the time.

This was illustrated earlier this month by analysts Dr Foster who found that hospitals were well above the recommended safe level for much of the year.

This creates a situation whereby bottlenecks can quickly appear if demand rises all of a sudden.

Last week 17 A&E units had to temporarily divert patients to other hospitals because they were struggling to cope.

Again that is not unusual at this time of year, but such steps are a last resort as they simply displace the problem rather than solve it.

When a system is operating at close to maximum the fear is that good planning and preparation can only go so far.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 18.

    12.kevthebrit - "...and ALL thanks to the great (self proclaimed) 'managers' of the NHS! NHS = NONE HEALTHY SYSTEM!"

    The Managers you referring to are properly known in the parlance as Bean Counters......

    ....& you'll find them inside Nos. 10 & 11 Downing St currently....(that's assuming Slasher Cameron isn't off one of his overseas jollies again at the moment.....)

  • rate this

    Comment number 17.

    "Can the NHS cope with winter"?
    Probably best to ask some(not ALL) of those consultants who have never been rostered to be geographically located at an actual NHS hospital over a weekend,and also ask the same ones if they're off skiing with their friends and families as well!??
    Surely a correlation with when consultants can take holidays with the peaks and troughs of demand is not to much to ask!?

  • rate this

    Comment number 16.

    How about a specific portion of extra duty on alcohol to go to the NHS? A&E wards on Fri/Sat nights in particular...

  • rate this

    Comment number 15.

    Never mind, whether the NHS copes or not is one thing but but thanks to the trillions spent on Trident and pointless wars around the world, we know it will be coping in a safe place. Just a matter of priorities really . . . . .

  • rate this

    Comment number 14.

    All proper hospitals (Public ones with A & E departments) have winter plans, trouble is Dave & Nick are deliberately shafting the NHS so that it can't cope, which will let their private friends in.

  • rate this

    Comment number 13.

    David Cameron said he'd "cut the deficit, not the NHS"......

    .....I bet Tony Blair admires the man for taking political spin to whole other level......

    ....David Cameron, PR man extraordinaire......

  • rate this

    Comment number 12.

    ...and ALL thanks to the great (self proclaimed) 'managers' of the NHS!

  • rate this

    Comment number 11.

    If the GP surgerys offered a good service with flexible hours (its not only people that are out of work or are retired that need a GP ) then Im sure A & E will be able to cope. Cant see that happening though

  • rate this

    Comment number 10.

    #9 Of course there's people like me. Terrible pain in my ear. First GP appointment I can get is 5 days time. 2 days later my ear-drum burst (actually relieving the pain) so I go to A+E with blood & pus running out of my head. 50p worth of antibiotics early on would have fixed me up. Instead I needed A+E, 2 outpatients appointments & have some permanent hearing loss.

  • rate this

    Comment number 9.

    The NHS will cope with winter providing people do not abuse the system and take appropriate care of themselves. The main culprits being those who use A&E at weekends instead of contacting the NHS Helpline or doctor.

  • rate this

    Comment number 8.

    #7 Flip side is that a funny looking mole probably is just a funny looking mole, a lump in your breast is almost certainly a cyst not a tumour and blood on the loo paper is probably piles. However decide not to bother your GP for a few months..... and the NHS has a HELL of a lot more work treating your much more advanced tumour when it turns out it isn't just a funny looking mole but a melanoma

  • rate this

    Comment number 7.

    If people went to the doctors for bonefide illnesses it would be a start.

    A common cold is not flu.

    Then theres the story of the little boy today whose Mother doesn't want him treated - the mind boggles???

  • rate this

    Comment number 6.

    the nhs has got its work cut out dealing with the thriving health tourist trade.

  • rate this

    Comment number 5.

    #4 Its called triage. If someone comes in to A+E with serious chest pains they get seen immediately. The drunks get seen when the staff have a chance. Its ONLY A+E that even has this problem... you don't get drunks in dermatology clinics so the impact on the overall NHS is minimal.

  • rate this

    Comment number 4.

    The NHS is maligned by too many people who abuse it, clog it up with self inflicted illness and then moan when it cannot deliver a remedy to them. The medical teams are expected to treat allcomers with equal dignity, but this has the effect of reducing the quality of service when it is overwhelmed by foolish behaviour leaving it unable to be efficient for those in genuine need. Drunks should pay.

  • rate this

    Comment number 3.

    It might help if a few people are arrested for being drunk and disorderly and locked up before they hurt themselves or anyone else.

  • rate this

    Comment number 2.

    The biggest threat to the NHS is the burgeoning population. Let us not forget that the NHS is the 5th biggest employer in the world, so plenty is being done to look after our sick, but if we keep filling the country with people, then this marvellous organisation will struggle.

  • rate this

    Comment number 1.

    The NHS is in a perilous state and has been for over 30 years due to continual political interference. The public also has a responsibility for this as most or all of the solutions are vote-losers and won't see the light of day to OUR detriment.


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