Patients have been warned to stay away from hospitals as trusts struggle with with an increase in patients due to the sub-zero temperatures and winter flu crisis.
Medics and trust leaders said they are fast running out of bed space having experienced one of the worst Christmas and New Year periods ever while A&Es have become increasingly busy.
Cornwall’s NHS services declared a critical incident on Friday evening after a week of sustained pressure on the main hospital and emergency department.
East Surrey Hospital and the Royal Stoke University Hospital have also declared critical incidents, prompted by high levels of demand and winter viruses, and frontline medics said they expect the situation to worsen.
A critical incident is something that can be declared by an NHS trust facing extraordinary pressure and tells staff, bosses and patients the hospital will not be able to function as usual. Patents have been told only to attend in a life-threatening emergency.
Kate Shields, chief executive of NHS Cornwall and Isles of Scilly integrated care board said: “We are currently seeing a high number of ambulances waiting outside the Royal Cornwall Hospital and of patients in our emergency department.
“There are also a large number of patients in Cornwall’s hospitals who are medically fit to be discharged but are awaiting the right care.
“Declaring a critical incident allows the NHS to take additional, immediate steps to create capacity, help discharge patients, relieve pressure on our emergency department and release ambulances and their crews.”
Although trusts’ leaders are not expected to issue black alerts over the weekend – where patient safety is not guaranteed – medics said the risk inevitably increases the more hospitals declare critical incidents. Black alerts usually mean hospitals have to divert patients elsewhere to receive emergency care.
Pressures are set to ramp up as a week-long cold snap will mean some parts of the UK dropping to -10°C, prompting the UK Health Security Agency to issue a rare health alert. Health Secretary Wes Streeting said this is “definitely a weekend to turn the heating on” and that people should wrap up warm and take precautions when going out.
The latest figures show the number of hospital patients with flu quadrupled to more than 5,000 at its peak last week. An average of 4,469 flu patients were in beds in England each day last week, including 211 in critical care. The figure rose by 17 per cent from the previous week and is more than four times the number on 1 December, when the figure was 1,098. However, it is lower than this point two years ago, when the figure stood at 5,441.
Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said A&E staff “are resigned to a severe increase in pressure over the winter period” and warned of an increase in avoidable deaths.
He said: “We have a system that is chronically overwhelmed. A chronic lack of beds and an unreformed social care system means that patients cannot be discharged when they are well enough.”
Hospital admissions in Scotland caused by the flu increased by 12 per cent in just a week. Public Health Scotland (PHS) described the amount of laboratory confirmed influenza this winter as “extraordinary” with prevalence at 52.6 per 100,000 of the population in the week up to December 29. PHS officials said a “substantial number of well-vaccinated” care homes have faced outbreaks, but thus far “only a small number of deaths have been reported”.
Professor Julian Redhead, NHS national clinical director for urgent and emergency care, said the figures “show the pressure from flu was nowhere near letting up before we headed into the New Year” and cases are “rising at a very concerning rate”.
Professor Redhead said: “On top of flu there is also continual pressure from Covid, while RSV and norovirus hospital cases are also higher than last year, with hospitals putting in place an extra 1,300 beds last week than the same time in 2024 in expectation of this continued pressure from viruses and other demand.
“With what looks like an extreme cold snap expected right across England ahead of the weekend, we know the low temperatures can be dangerous for those who are vulnerable or have respiratory conditions so if you are at risk, do try and keep warm and make sure you are stocked up on any regular medication.”
Hospitals have also been dealing with a surge in the number of patients with diarrhoea and vomiting or norovirus-like symptoms, respiratory syncytial virus (RSV) and Covid-19.
Dr Tim Cooksley, of the Society for Acute Medicine, said the “quad-demic” had “entirely predictably” plunged many hospitals into crisis.
“The lack of bed capacity with hospitals being overstretched throughout the year means there was no ability to cope with the inevitable strain of winter viruses – let alone a tough flu season,” he said.
“This has led to increased degrading corridor care, prolonged waits and the resulting patient harm – and the further predicted cold snap will exacerbate this. It will be a dire few months for patients and staff in urgent and emergency care and throughout the entire NHS and social care system.”
Dr Cooksley also criticised the Government for delaying the social care reform review until 2028 at the earliest. “[That is] deeply disappointing and misguided thus ensuring overcrowded hospitals, delays to care and resultant deaths for at least another five years. This is not acceptable.
“Demand will for healthcare will not reduce. We need to restore patient and staff confidence that people will receive timely and high-quality care. The current stasis in decision-making is unconscionable.”
“There are reports that some trusts are now having to cancel planned operations in order to deal with urgent seasonal pressures at the moment, so it’s going to be a bumpy start to the year,” said Sarah Arnold, senior policy lead at the King’s Fund.
“Health leaders are having to navigate thinking about keeping patients safe in A&E through winter, alongside the more long-term ambitions to shift more care into the community, have a focus on prevention and accelerate a shift from analogue to digital in the NHS.
“So there are lots of priorities to juggle. And the backdrop is extremely tight financial constraints.”
Ambulance handover delays were down slightly week-on-week but higher than this point last year, the NHS England figures show. Some 12,229 patients (12.9 per cent) were delayed by more than an hour.
Adam Brimelow, of NHS Providers, said: “These figures show services coming under relentless pressure and it looks like things will get worse before they get better. This week’s cold snap is likely to add to already huge demand for NHS services. It feels like the worst Christmas and New Year the NHS has seen for many years, according to some trust leaders.
“The winter flu blitz came early with A&Es and wards exceptionally busy and in many places ambulances having to queue outside hospitals, waiting to bring in patients. The total number of people in hospital with flu and other viruses is much higher than this time last year.
“In the face of persistent demand and pressure NHS staff and trust leaders continue to roll up their sleeves and see patients as quickly as possible.”
NHS Confederation chief executive Matthew Taylor said: “The NHS has done all it can in advance to mitigate risks to patients this winter, but we should be under no illusions that the service is in a position of national vulnerability as the intense pressures we are now seeing start to grip local services.
“These winter stats bear out what local NHS leaders have been telling us directly in recent days – that the NHS is facing huge demand, from sicker patients, with very high levels of flu to deal with. The next two to three weeks will likely be the busiest period of the year for many local services and we need to acknowledge the strain that this will place on staff and services.”
It comes amid concerns the crisis will overshadow Keir Starmer’s NHS relaunch on Monday. As one senior minister puts it: “There’s a risk that this Government sole mission becomes the health service – if it doesn’t then improve we are in serious trouble.”
Another Labour MP said: “Wes has talked a good game but there isn’t much in terms of results or substance yet.”
Temperatures of -10°C could be seen in parts of rural Scotland on Friday night, according to new Met Office forecasts. The coldest temperature recorded in January last year was -14°C, in Dalwhinnie in the Highlands.
Met Office Officials say power cuts are likely and there is also a “good chance” that rural communities could be cut off due to the conditions, with up to 30cm of snowfall expected locally.
An amber warning for snow and freezing rain covering most of Wales and central England, including the Midlands and the north-west cities of Liverpool and Manchester, is in place from 6pm on Saturday to midday on Sunday. The second warning for snow, covering most of northern England including Leeds, Sheffield and the Lake District, has been issued from 9pm on Saturday to midnight on Sunday.
Both of the warning areas can expect to see 3cm to 7cm of snowfall widely, while snow may mix with rain at times in lower-lying areas, the forecaster said. Three separate yellow weather warnings for snow and ice are already in place for most areas of the UK, covering different periods of time from Friday to Monday afternoon.
Met Office chief forecaster Jason Kelly said some “significant accumulations” of snow are possible in parts of Wales, the Midlands and northern England, and the additional factor of strengthening winds could lead to drifting of lying snow.
He said: “There is a risk of freezing rain across parts of the Midlands and northern England, but especially Wales, adding to the risk of ice and leading to some treacherous conditions in places. As the super-cooled rain droplets hit the surface they instantly freeze, covering everything in a layer of ice, making it extremely dangerous.”
UK Health Security Agency (UKHSA) cold weather health alerts for all of England remain in place ahead of a week of low temperatures. Amber alerts were issued on Thursday and will run until January 8, meaning a rise in deaths is likely, the agency said.
Dr Agostinho Sousa, head of extreme events and health protection at UKHSA, said: “The forecasted temperatures can have a serious impact on the health of some people, including those aged 65 and over and those with pre-existing health conditions, and it is therefore vital to check in on friends, family and neighbours that are most vulnerable. These people could be more at risk of heart attacks, stroke and chest infections as a result of cold temperatures.”
The Royal College of Nursing (RCN) warned worse is to come for staff and patients.
RCN Executive Director for England Patricia Marquis said: “Nursing staff know even more challenging conditions are on the horizon. They are deeply concerned there is no end in sight to patients being treated in corridors and care being compromised.”
