Winter pressures on NHS show ‘no sign of easing’ ahead of fresh strike by doctors

Winter pressures on the NHS in England are showing “no sign of easing”, with high levels of flu and ongoing struggles to clear beds of people fit to leave, health chiefs have warned.

Ambulances are continuing to face long delays in handing patients to A&E teams, at the same time as the NHS is preparing for a fresh round of strike action by junior doctors later this month.

An average of 2,390 people were in hospital in England each day last week with flu, including 98 in critical care beds.

The total is down slightly by 4% from 2,478 the previous week, which was the highest figure so far this winter, but is still up 82% since the start of January, according to NHS data.

Flu infections this year have surged at a later point than last winter, when cases peaked at Christmas and then fell rapidly – although last’s year outbreak saw hospital numbers top 5,000, in what was the worst flu season in the UK for a decade.

This year’s outbreak has yet to see figures reach a similar level.

Meanwhile, 33% of hospital patients in England arriving by ambulance in the week to February 11 had to wait more than half an hour to be handed over to A&E teams.

This is up from 31% in the previous week and is close to this winter’s peak of 34%, which was reached at the end of January.

The figure is well above the level at this point last year, which was 20%.

Some 13% of patients had to wait more than an hour to be handed over last week, up slightly from 12% the previous week and above the 7% at this stage in 2023.

Handover delays of new patients can reflect a shortage of beds on wards, which in turn is affected by delays in discharging people who are medically fit to leave hospital.

An average of 13,766 hospital beds per day last week were occupied by people ready to be discharged.

This is down from 14,252 the previous week, but remains well above levels seen for much of the winter.

Sir Julian Hartley, chief executive of NHS Providers, which represents NHS trusts in England, said that pressures on hospital beds were “unrelenting” and demands on the NHS showed “no sign of easing”.

Delays in discharging people were “stubbornly high”, with thousands of beds taken up every day by “patients who are fit to be recovering at or close to home but can’t be discharged, often because of a lack of social care capacity in the community,” he added.

“Trust leaders and their teams are also having to prepare for another round of highly disruptive strike action by junior doctors in just over a week.

“In the face of these challenges, trust leaders and their teams are doing everything they can to treat patients as quickly and as safely as possible.”

Junior doctors in England will take strike action from 7am on February 24 to 11.59pm on February 28 – their 10th walkout in a long-running dispute over pay.

The latest hospital performance figures also show that norovirus levels are broadly unchanged, with an average of 561 adult beds filled last week by people with diarrhoea and vomiting or norovirus-like symptoms.

This compares with 568 the previous week, a very slight fall of 1%, and is down from a peak of 688 beds a fortnight earlier.

An average of 3,232 people who had tested positive for Covid-19 were in hospital last week, down 10% from 3,599 the previous week and 24% below this winter’s high of 4,245 in early January.

Covid-19 patient numbers peaked at more than 9,000 last winter.

Professor Sir Stephen Powis, NHS England national medical director, said it was clear that seasonal pressures on the NHS were “not letting up”, with high levels of flu and bed occupancy combining with “continued high demand for ambulance services and NHS 111”.

He added: “The robust measures in our urgent and emergency care recovery plan and early winter planning have ensured we have more beds in place this year compared to last, and innovations like our virtual ward programme and same day emergency care units are helping.

“But there is no doubt staff are continuing to face one of their busiest winters ever.”

Rory Deighton, acute network director at the NHS Confederation, the membership organisation for the healthcare system, said this winter is “one of the toughest the health service has ever faced” with cold snaps and industrial action “piling on the pressure”.

He added: “There are still far too many patients in hospital who are well enough to leave, bed occupancy levels are too high, and ambulances are still facing delays handing patients over at A&E.

“Our members are concerned that funding problems in social care are causing a shortage of the vital care packages needed to help the NHS free up beds and get the system flowing again.

“While health leaders and their teams will pull out all the stops to fill rotas ahead of further junior doctor strikes, the upshot will be more patients having their operations or appointments cancelled and efforts to tackle the backlogs set back.

“It is not too late to restart negotiations and stop the strikes before more patients have their vital care delayed.”