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 58.

    Can't think of anything else to put up as a topic then?

  • rate this

    Comment number 57.

    What a pointless question.

  • rate this

    Comment number 56.

    Stop scaremongering!

  • rate this

    Comment number 55.

    If it employed "bean counters" to manage such a system it would be accused of being bloated by the obsessive anti public sector/ vested interest lobby.

  • rate this

    Comment number 54.

    Can I point out to the "doom sayers" that people survived several waves of black death, the post WW1 flu(?) pandemic, swine flu and other end-of-the world scenarios. You have to die of something but most of us in UK are among the longest lived and healthiest generation in history. Good infrastructure, decent diet and the brilliant NHS are all helping. Don't knock NHS or health professiona

  • rate this

    Comment number 53.

    "That's because services can be borrowed from adult wards"
    So the adults can go without!
    Is it only me that sees this arrogant self centered rich boy disgrace of a Government for what it is?
    Is everybody fooled by the idiot Clegg supporting it?
    This is a dangerous uncaring group of individuals who care nothing for those without wealth and influence.
    How can the NHS work under this leadership

  • rate this

    Comment number 52.

    The NHS, like schools, is an ideological playground - incessant "big" government interference has been incredibly damaging and very costly.

  • rate this

    Comment number 51.

    The NHS would cope much better if A&E dept charged people for accidents which happen when either drunk or incapable due to drugs. The NHS is wonderful when needed but it is so very often abused by those who do not pay for it, unfortunately if charges were levied it would cost to much too collect. A billion £ a day would not be enough as new treatments need more money, there will never be enough

  • rate this

    Comment number 50.

    The NHS is now the OHS = Overstretched Health Service.
    Soon to be the PHS = Privatised Health Service.

    Swipe your credit card on entry.

  • rate this

    Comment number 49.

    The NHS, run into the ground by tories, for the benefit of tories.

    They won't stop until they've completely Americanised the UK.

  • rate this

    Comment number 48.

    As a GP I'd like to encourage patients to take some responsibility for their own health. Accept that viruses cannot be cured. Realise that coming to the surgery involves the risk of infecting other vulnerable patients in the waiting room, and also the staff (we're humans too!) Consider a phone appointment instead.

  • rate this

    Comment number 47.

    Is this some kind of joke?
    Wards are closing all over the place, hospitals all running even further into debt, and you need to ask if they can cope with the winter, they are not coping now,
    private patients getting priority in NHS hospitals and medical centers is offensive to people who have had ops canceled many times in favour of the elite.

  • rate this

    Comment number 46.

    Until this Government's real cuts kick in fully. Its like when you put off maintenance on your house. You get through a Winter or two without a disaster, but when it all gives way, the result is far worse. The NHS is being destroyed and huge chunks handed over to incompetent privateers.Soon we'll have a campaign for thick woolly hats for paupers cause the beds are blocked by private bunion surgery

  • rate this

    Comment number 45.

    The N"H""S" hasn't been able to cope at any time of the year for a long time; cuts and this government's policies have nothing to do with it. A large part of the problem stems from the 2004 contract that allowed lazy, greedy GPs to give up out-of-hours work while doubling their pay. Lack of primary care for most of the week put pressure on A&E, where people were forced to go as a last resort.

  • rate this

    Comment number 44.

    41.The Rockabilly Red

    '.....the NHS has always claimed to be on the point of collapse' .Errrmmm No - the Tory party and its media mates have always claimed this - not the NHS. The NHS has strive to manage, despite the pressures it's subjected to by governments of all persuasions.

  • rate this

    Comment number 43.

    There should be no worries over seasonal variables in admissions if we didn't have far far to many people in our country and if access to the NHS was only granted to people and their families who have and do pay in to it.The NHS like our other public services HAS TO BE PAYED FOR,we have to stop this" something for nothing culture" Wake up Britain!

  • rate this

    Comment number 42.

    1000 extra deaths a week because of the cold is a lot more than I thought. I hate winter with a passion. Spring and Autumn are rarely much better here, we get about 3-4 months (if we're lucky) of ok ish weather followed by 8-9 months of hibernation. I'm spending 2/3 of my life wishing it was warmer!

    Oh for a big lottery win, I'd be in the Canaries or Southern California for those 8 months.

  • rate this

    Comment number 41.

    I'm in my 50's. I've followed the news of the day for as long as I can remember. This may be my imagination, but can anybody remember a time when the NHS wasn't in crisis? No matter what steps have been taken, by any government, the NHS has always claimed to be on the point of collapse.

    Perhaps it's time to scrap it and start again?

  • rate this

    Comment number 40.

    A better title to the article would be

    "Can the NHS cope with the DEBT?"

  • rate this

    Comment number 39.

    My wife, a teacher at a local primery school, the past 4years every term she got the cold and other associated illness. A friend gave up nursing, after a lot of time & training to become one, because she spent too many days off-sick. It might help to give flu jabs to all frontline staff like teachers and nurses. My wife got it for £9 at a local supermaket and she has not had a day off, yet.


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