Some pinch points coming up
We’re off to the start of winter 2022/3, and the NHS have started publishing their winter sitreps - weekly updates breaking down bed demand, capacity and other pressures on the NHS.
The overall picture is - as I’ve said before - on a strikingly close trajectory to the winter of 2022/3, when we saw such an appalling situation in the last few days of December that emergency care was - effectively - not functioning for several days.1
There are many, many ways of looking at the statistics, but one way of looking at overall pressure is to just ask - very simply - how many beds (G&A = general and acute) are occupied at this point in the year vs previous years. This year, we’re starting off pretty much bang on 2022/3.
There are some things that are better, and a few that are worse vs last year.
Things that help vs last year:
COVID pressure is down and dropping. We’ve ~2,300 in hospital in England with COVID right now, with about 550 primarily there due to COVID.2 There were more than twice as many this time last year, and more than 3x being treated primarily for their COVID. Pressure is enormously lower.
Flu is not here (yet). 166 flu beds this so far year (baseline, pretty much) with all of 9 people in intensive. Last year was already 675, with 60 in intensive care. And then this was the final pressure that pushed the system over, when flu ramped from there to 5,700 in late December.
Staff are a fair bit healthier. Fewer NHS staff are off sick this year (about 45k in late November 2023 vs 55k same time last year). Makes a big difference.
Things that don’t help vs last year:
Norovirus, Diarrhea and Vomiting. Yuck. Lots, around 540 beds closed, compared to ~300 last year, and it’s escalating fast.
RSV is high (even higher) this year, More beds occupied, more critical care occupied (though only marginally in each case) - this hits paediatrics hardest.
But all in all, what is most striking is not the differences to last year. It’s the similarities.
Despite all the targets, all the political promises, the picture on the chart above - though massively incomplete - is actually fairly representative. There are about the same number of beds occupied, about the same number of beds free, about the same number of long-stay patients … and as a result, pretty much the same horrific emergency room and ambulance delays ramping up as we had last year.
Despite all the promises, NHS capacity is pretty much the same (if not a little worse) than it was and the system is just as vulnerable as it was last year (if not a little more).
Pinch points - still in the South West: shifting towards the Midlands?
Let’s take two areas which are looking particularly vulnerable this year - and look at how they are handling the pressure. As is - unfortunately - traditional, the South West is under pressure.