England’s public health service is facing a “storm of pressure” as the year draws to a close, with the threat of industrial action looming heavy over an already-stretched system.
The number of patients in hospital with winter viruses like flu and norovirus has risen sharply in recent weeks, as have the number of cases of Covid-19 in the country.
Experts fear this combination of illness and strikes will put significant pressure on the health service over the coming weeks.
But some areas are performing better than they have in recent years, offering glimmers of hope amid an otherwise gloomy outlook.
Steven Powis, medical director for England’s public health system (the National Health Service) said there are “hundreds” more beds available than this time last year, and far fewer ambulance hours being lost to delays at hospital emergency rooms.
Call handlers for the country’s non-emergency health hotline, he added in a statement, were answering twice as many calls under a minute as this time last year.
Nonetheless, England’s hospitals still face a challenging new year.
Winter viruses
Winter is always a difficult time for healthcare services because of the circulation of viruses like flu, RSV and norovirus (often called the “winter vomiting bug” in the U.K.).
Although most people can weather winter sickness at home, some will need hospital care. Health service staff themselves may also become sick, reducing capacity to take on new patients.
Campaigns to vaccinate staff against flu are a big part of winter planning for hospitals and other healthcare providers. But the shots aren’t 100% effective — and not every member of staff will get them — so sickness absence still usually rises in winter.
At present, nearly 1,000 patients across England have been hospitalised with flu: a six-fold increase over the last month.
And nearly 500 patients are in hospital with norovirus — nearly double the amount hospitalised with the illness than this week last year.
Covid-19
Although it isn’t contained to the winter months like flu, Covid-19 still represents a particular threat in winter, as it exacerbates all of the pressures already placed on health providers by seasonal viruses.
It increases demand for hospital beds and keeps staff off sick.
At the moment, Covid-19 is also on the rise in the U.K. More than 3,600 hospital patients had the virus on Christmas Ever: an increase of nearly 60% on the month before.
“These figures demonstrate the storm of pressure the NHS is facing… with huge rises in flu patients over the last few weeks and many more norovirus cases than we saw last winter, as well as the ongoing impact of Covid – all on top of the added pressure of industrial action,” Powis said.
“As always I would urge the public to get their Covid and flu vaccines if they are eligible.”
Strikes
Various groups of public health service staff have walked out over the last year in disputes over pay and working conditions. Nurses, doctors, ambulance staff and others have taken part in industrial action.
Many of these campaigns appear to have come to an end — or at least a pause —following pay deals with government. But some are ongoing.
England’s junior doctors — who are fully qualified and may have up to eight years’ clinical experience — walked out for three days in the run up to Christmas. This action led to the cancellation or delay of more than 86,000 routine appointments.
They plan to strike again from January 3 to January 9: a lengthy demonstration that’s likely to have a major impact on hospitals’ ability to provide planned care.
When junior doctors go on strike, hospitals tend to focus resources on emergency services. This means that elective surgeries, outpatients appointments and other planned care may end up being delayed.
Junior doctors have already walked out several times over the last year. They announced this latest series of strikes after ministers offered senior doctors a more generous income boost after their own industrial action.
The move also riled nurses, who paused their own strikes earlier this year after other groups of striking staff accepted a pay deal. Nursing union leaders voted had against the deal, but no further action took place after union members lost their appetite for strikes. It remains to be seen if nurses hold further action.
Julian Hartley, chief executive of hospital industry group NHS Providers, urged government ministers and leaders from the British Medical Association, who are organising the junior doctor strike, to come to a solution ahead of the planned strike.
He said his organisation wants both parties “to think afresh, and find a way to resolve the damaging and demoralising industrial dispute which has caused so much disruption for patients.”
He added: “There is still time to head off the longest strike in the history of the NHS, which is planned to get under way next week.”
