NHS pressures 'simply unsafe' as first winter report shows hospitals full with Christmas approaching

Alex Matthews-King
NHS England has tasked hospitals with cutting delays in getting patients from an ambulance into A&E: Getty

One week into winter and health service pressures have been deemed “simply unsafe” by experts, after the first instalment of the NHS’s weekly winter progress report.

Around one in 20 hospital beds (5.5 per cent) in England are available as the NHS heads towards Christmas, posing major questions about its ability to respond as seasonal pressures increase.

The NHS Confederation, which represents organisations across the health service, said the figures “tell a very alarming story at this stage in winter – hospitals are nearly full”.

The figures come from NHS England’s first Weekly Winter Operational Update of the year, a run down of how the service is coping; including flu related deaths, ambulance delays, and beds quarantined in outbreaks of diarrhoea and vomiting.

NHS England wrote to trusts in July with directives for this winter that said bed occupancy nationally should not exceed an average of 92 per cent.

But the standard used by experts, and set out in an earlier National Audit Office review on hospital demand, has said that trusts with occupancy regularly over 85 per cent risk “bed crises” and greater levels of hospital-acquired infections.

The fact that the NHS is already exceeding both targets nationally is cause for concern, but quarterly data, published in September and broken down by trust, shows four areas were already running at more than 98 per cent capacity.

This is despite a £1bn Government investment in social care provided in the spring budget to speed up the discharge of patients from hospital into the community.

High bed occupancy is a particular concern with the NHS on high alert for a particularly bad bout of winter flu, after hospitals in Australia and New Zealand dealt with record numbers of cases during their winter season.

Doctors’ leaders said today that a sudden cold snap could mean the system “would really struggle”.

However NHS trust representative body, NHS Providers, said the extra effort put into winter preparations earlier this year had helped, even though performance is running roughly similar to last year.

The Labour Party focused on the delays in ambulances being able to handover patients to hospitals, warning that the NHS faces a “winter of misery” with more than 10,000 patients waiting at least 30 minutes outside A&Es last week.

A fifth of these waits lasted more than an hour.

This is despite the NHS writing to trusts warning that delayed handovers between ambulances and A&Es would be a national priority to prevent a repeat of last year’s record waits.

A fortnight ago Chancellor Philip Hammond awarded the NHS £335m “for pressures this winter” in the Autumn Budget, despite NHS England chief executive Simon Stevens asking for the £350m a week pledged by Brexit campaigners.

NHS Confederation chief executive Niall Dickson said of the figures: “This level of system pressure is quite simply unsafe and is putting patients at risk.

“There is a real human cost here. On two days in November there was only one Paediatric Intensive Care Unit bed available in the whole of London.

“Parents who have spent months preparing their children for urgent operations are turning up at hospital only to be told they have been cancelled.”

Chris Hopson, chief executive of NHS Providers said their winter plans are “being put to the test” but the early preparation was paying off.

“It is very early days but it is clearly a concern that bed occupancy – with an average rate of 94.5 per cent – is already running so high as we head into what is usually the busiest time of the year.

“Most indicators that can be compared to last year suggest that we are in a similar – or slightly better – position than at the same stage last year.

“This is welcome and shows that, given demand is growing, the amount of preparation ahead of winter undertaken by NHS trusts and national bodies is already proving helpful.”

An NHS England spokesperson said: “The NHS has prepared for winter this year more intensely than ever before, developing robust plans to manage expected increased pressures, as well as create contingency plans to cover exceptional surges in demand.”

They added that the public should ensure they have had their flu vaccinations and turn to services like the NHS 111 helpline for non-urgent medical advice.

Labour Shadow Health Secretary Jonathan Ashworth said: “After an inadequate Budget for the NHS, healthcare leaders warned of an imminent and unprecedented winter crisis.

“Today’s data reveals a stark picture of what lies ahead: a winter of misery for patients and unparalleled pressures on our NHS staff.”

British Medical Association chair, Dr Chaand Nagpaul, said: “These figures show a service under huge pressure with little or no spare capacity as the NHS approaches its busiest time of the year.

“The concern is that that if there is a serious flu outbreak or cold snap the system would really struggle to deal with a spike in demand.”