Other Northern European nations, North America etc. have more extreme and colder Winters, yet their health systems appear not to buckle under these predictable seasonal pressures. Here are some recent responses and initiatives, as mentioned in the news, aiming to minimise the harmful / disruptive effects of this possibly unique UK socio-political phenomenon.
Mitigation Strategies in General Practice / Primary Care
The Royal College of General Practitioners (RCGP)’s “three before GP” mantra advises patients to consider three alternatives before accessing their GPs.
Take three steps before visiting GP, public urged. London: BBC Health News, December 29th 2017.
This relates to:
‘3 before GP’: new RCGP mantra to help combat winter pressures in general practice. London [Online]: Royal College of General Practitioners (RCGP), December 29th 2017.
The Role of Community Pharmacists
An example regional community pharmacists’ “Right Care, First Time” campaign, based in Bristol, North Somerset and South Gloucestershire.
Winter pressure health campaign launched in Bristol. London: BBC Health News / BBC Bristol News, December 26th 2017.
Mitigation Strategies in Acute / Secondary Care
Around 55,000 non-urgent NHS routine operations and elective hospital procedures in England will be deferred for a further month, as part of a planned strategy to divert key staff into emergency care.
Therrien, A (2018). Hospitals to delay non-urgent operations. London: BBC Health News, January 3rd 2018.
See also, the rationale for this step from NHS England’s National Emergency Pressures Panel (NEPP):
Operational update from the NHS National Emergency Pressures Panel. [Online]: NHS England, January 2nd 2018.
Further commentary from BBC News:
“As well as the cancelling of non-urgent treatments, such as knee and hip replacements, hospitals have been given the green light to put patients on mixed sex wards and to bring GPs into A&E to help deal with patients”.
Therrien, A [and] Triggle, N. (2018). Health secretary Jeremy Hunt sorry as A&Es struggle to cope. London: BBC Health News, January 3rd 2018.
This builds on earlier prioritisation decisions to cancel non-emergency operations, along similar lines a couple of weeks previously:
Triggle, N. (2018). Hospitals to cancel ops to cope with winter surge. London: BBC Health News, December 21st 2017.
The impact of delays on elective patients:
Operation delays: ‘Everything is up in the air’. London: BBC Health News, January 4th 2018.
Triggle, N. [and] Calver, T. (2018). Ambulance A&E delays hit one in eight. London: BBC Health News, January 4th 2018.
More anecdotal reports:
A&E: People on beds ‘as far as you could see’. London: BBC News: Hereford and Worcester / BBC Health News, January 3rd 2018.
Dangerous Overcrowding Linked With Death?
Northampton General Hospital: Man, 85, ‘died due to overcrowding’. London: BBC Health News / BBC News Northampton, March 8th 2018.
The pressure (on public opinion) never lets up:
Triggle, N. (2018). We’ve run out of beds, warn hospital bosses. London: BBC Health News, January 10th 2018.
More fundamental uncertainties about official statistics, if doubts were needed:
Kirkland, F. (2018). A&E stats may have to be recalculated. London: BBC Health News, January 22nd 2018.
Further analysis regarding the allegation of artificial inflation of A&E performance figures:
Pym, H. (2018). How accurate is hospital A&E data? London: BBC Health News, January 26th 2018.
Pym, H. (2018). A&E stats don’t tell full story of a difficult winter. London: BBC Health News, February 8th 2018.
NHS England recorded its worst-ever A&E annual performance (88.4%) since records began in 2004:
Triggle, N. (2018). The 10 worst A&Es for waits revealed. London: BBC Health News, April 12th 2018.
Ed Humpherson, Director General for Regulation at the UK Statistics Authority (UKSA) has cautioned NHS England about delays and potential inaccuracies in reported A&E performance statistics:
Pym, H. (2018). A&E statistics ‘worse than reported’. London: BBC Health News, May 17th 2018.
Scottish A&E performance no longer bucking the general UK trend
Scottish A&E waits at highest level in final week of 2017. London: BBC Scotland News / BBC Health News, January 9th 2018.
This despite earlier optimism about system resilience:
Scottish A&E bucks trend on long waits. London: BBC Scotland News / BBC Health News, December 7th 2017.
Scottish NHS waiting times performance at new low. London: BBC Scotland News / BBC Health News, January 16th 2018.
Struggling to Comprehend
Big-picture analyses of the many issues at play:
Triggle, N. (2018). 10 charts that show why the NHS is in trouble. London: BBC Health News, January 5th 2018.
Flu, an additional contributory factor (yet hardly unpredictable)?
Sharp rise in flu hospital admissions in England. London: BBC Health News, January 4th 2018.
Flu cases increase:
Flu cases: surge in hospital admissions. London: BBC Health News, January 11th 2018.
Politics Via the A&E Front-Door?
The NHS has prepared specially for Winter over the past year (more so than ever before); not that the Prime Minister has been thanked for reminding the nation of self-congratulatory statements, just a few months old, arising from NHS England and NHS Improvement. Who would have believed a deterioration so stark, rapid, and so soon, would be possible?
There are underlying political narrative(s), which may shed more light on current events, and the battle for public opinion, than first meets the eye. A King’s Fund compilation of insights is available:
NHS winter pressures. [Online]: King’s Fund, January 2018.
Triggle, N. (2018). Why 2018 will be a very special year for the NHS. London: BBC Health News, December 27th 2017.
The need for a non-partisan style of long-term funding solution is under discussion (not that throwing money at certain problems would necessarily solve them, going by past experience):
Pym, H. (2018). Funding the NHS: Is it finally time for a new approach? London: BBC Health News, January 6th 2018.
Further political analysis:
Kuenssberg, L. (2018). Time for an answer on the NHS? London: BBC Politics News / BBC Health News, January 11th 2018.
Playing the “patient safety” joker card? Yet another “watershed moment” in the making for the NHS, pressed home by NHS Providers and a letter, signed by 68 senior A&E doctors, to the Prime Minister:
Triggle, N. (2018). Patients ‘dying in hospital corridors’. London: BBC Health News, January 11th 2018.
All Things Must Pass
The road to recovery:
NHS England lifts suspension on non-urgent operations. London: BBC Health News, January 26th 2018.
Flu less of a problem:
Winter flu outbreak is peaking, say health experts. London: BBC Health News, January 25th 2018.