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

Why are hospitals under so much pressure?

The NHS across the UK is already struggling to meet its A&E targets, and winter - the busiest time of year - has only just begun. Nick Triggle looks at why hospitals are under the cosh.

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  • rate this

    Comment number 38.

    Many OAPs with their experience of life cope well with the panics put out by the rolling news channels.
    They buy what they NEED,count the pennies,AVOID the doctor and hospitals like the plague.
    Theyalso keep warm,with warm clothes helping central heating.
    Being from the days when people had to do for themselves the old are probably better able to cope, as they KNOW some scare stories are untrue!

  • rate this

    Comment number 37.

    Can the NHS cope with winter?
    You do the figures.

  • rate this

    Comment number 36.

    Of course it cannot cope. Consultatns only working part week. Nurses wanting to be doctors and no-one wants to do the hard work of nursing. must easier to stand and talk and leave the rest to care assistants. We pay for all this and if it was a shop we would boycot it but of course we cannot boycot the health service so improve. it doesnt take money to care.

  • rate this

    Comment number 35.

    NHS cannot cope as its run by `crats.
    However, BBC and other media regularly bringing up H2N1 and the "Vomiting bug" which according to BBC news is "Very common"doesn`t help
    I never heard of it before BBC began getting into winter worry mode.
    As for hospitals, as a regular visitor to A&E I see professional nurses regularly neglect to use the anti septic hand cleaners.H A Infection NOT a mystery!

  • rate this

    Comment number 34.

    Can it cope?.Yes, but will service be what you expect in a Developed nation, probably not.What do you expect,when the A&E at the weekend is like a MASH Unit, and recently I must say Nurses are not exactly the caring profession,4hr waiting times standard they almost don't want to go near patients.Can't really blame them though,cut after cut due to PFI and extortionate drug prices.

  • rate this

    Comment number 33.

    I guess it depends a lot on the weather. No ice lots less hips arms wrists broken. As someone else said triage. The drunk or the girl who's fell off her heals can wait just as long as their not serious, that's why you have triage. I'm sure the staff on duty will do their best.

  • rate this

    Comment number 32.

    Open the doors, let em all in, it'll be fine and good for the economy!

    It's not fine, it's pretty far from fine, it's a growing national disaster and all our 'top boys' can do is offer weak and useless 'youth club' legislation delaying the 'man made' inevitable.

  • rate this

    Comment number 31.

    Since the NHS was formed in about 1948 nobody has become immortal, everybody still dies.
    It is better sanitation, food, living and working conditions that have brought about better health not the health service.

  • rate this

    Comment number 30.

    More to the point can it cope with PFI payments forced on it by the politicos.

  • rate this

    Comment number 29.

    What a ridiculous thing to ask. If the NHS can't cope, why pay NI?

    NHS = money flushed down the toilet by the billions. Why? Not because too many are ill/fat/smokers,etc and need care (that's the whole point of the NHS!) It's because drugs and equipment are too expensive. Healthcare is one of the world's most lucrative profiteering scams and all at the expense of peoples' health. Ridiculous.

  • rate this

    Comment number 28.

    Can Not Cope With Anyting!!!!!!!!!!!!!!!!!!!!!! and all every body does is blame the goverment . there is alot more wrong than that ! open your eyes and minds

  • rate this

    Comment number 27.

    The Department of Health in England tries to relieve the pressure by offering flu vaccinations to the most at risk groups. What is the point, the vaccine was based on last years flu, be it Bird, Swine, or Ash Tree Pollen flu. There will be plenty of vomiting ,during the festive period. What has happened to AIDS,10 years ago it was surposed to decimate the world population

  • rate this

    Comment number 26.

    Nope. But it's going to do it anyways.

  • rate this

    Comment number 25.

    24. Disillusioned
    "Well until it stops being a world health service of course it cannot cope."

    Is that a reference to the dependence of the NHS on the many medical staff from foreign countries or are you referring the to tax paying patients whose families originate from other countries? Either way your comment stinks and is nothing to do with the real-world cuts being imposed by this government.

  • rate this

    Comment number 24.

    Well until it stops being a world health service of course it cannot cope.

  • rate this

    Comment number 23.

    Should be quite a winter as more and more people turn the heating down and queue up for food hand outs.

  • rate this

    Comment number 22.

    IF GPs surgeries were open 7am to 9pm 7 days a week, then they could see a hell of a lot more people, so relieving the pressure on A&E. Drunks in A&E should have to pay full whack (as in Czech Republic, a country where alcohol is popular), and hospital OPD run 7 days a week, but if patients don't come, they have to pay the BUPA rate. That would sort the sheep from the goats!

  • rate this

    Comment number 21.

    Whilst we're talking NHS,and I know we're pumped full of positive media daily about the young couple,but does no one question Kate's use of the private King George VII hospital,surely when you are representing the people of the country,be it in Government or indeed Royalty you should be using the same State owned hospitals and schools,if your a private citizen you have no such obligation!?

  • rate this

    Comment number 20.

    If GP surgeries were nationally forced to adopt the same guidelines operated by the best of them rather than what suits them, improper use on hospitals would be unnecessary.
    There are some GP surgeries that work for what suits themselves rather than the patient.

  • Comment number 19.

    All this user's posts have been removed.Why?


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