The NHS is facing a “quad-demic” of health emergencies as it heads into winter, with hospitals “busier than ever” for this time of year, the health service’s most senior doctor has said.
The number of people in hospital with flu in England has more than quadrupled compared with last year, while cases of Covid, norovirus and respiratory syncytial virus (RSV) are also on the rise.
Prof Stephen Powis, the national medical director of the NHS, said he feared the number of admissions would increase further unless the public took action to protect themselves with flu, Covid and RSV jabs. RSV is a common cause of coughs and colds, and can lead to bronchiolitis or pneumonia particularly in young children and the elderly.
His warning came as the number of people in hospital in England with flu rose to more than four times the figure at this point last year.
According to the first of this year’s NHS winter situation reports, an average of 1,099 flu patients were in beds in England each day last week, including 39 in critical care.
This is up sharply on the equivalent numbers for the same week in 2023, when the total was 243 with nine in critical care. It is also higher than this point in 2022, when there were an average of 772 flu patients.
Powis said with the long winter months to come, there are concerns about unprecedented pressure on health services.
“For a while there have been warnings of a ‘tripledemic’ of Covid, flu and RSV this winter,” he said. “But with rising cases of norovirus this could fast become a ‘quad-demic’ so it’s important that if you haven’t had your Covid or flu jab to follow the lead of millions of others and come forward and get protected as soon as possible,” he said.
“The NHS is busier than it has ever been before heading into winter, with flu and norovirus numbers in hospital rising sharply – and we are still only at the start of December, so we expect pressure to increase and there is a long winter ahead of us.
“Ambulances are also facing huge demand, with thousands of extra patients and other pressures having an impact on handover delays, which is why our robust plans, including services like urgent treatment centres and same day emergency care are so important this winter.”
His message was echoed by England’s chief medical officer, Prof Chris Whitty, who posted a chart on X showing the rise in flu cases compared with the previous year.
Influenza is now rising rapidly. Antiviral ‘flu medicines can now be used in primary care.
If you are eligible please get vaccinated.
For healthcare workers, being vaccinated helps protect you, your patients and colleagues.https://t.co/eo5MFz6Hvs pic.twitter.com/F00W1nI6oh
— Professor Chris Whitty (@CMO_England) December 3, 2024
The figures in the winter situation report show an average of 751 adult hospital beds in England were filled last week by patients with diarrhoea and vomiting or norovirus-like symptoms, compared with 406 at this point last year and 318 in 2022.
The total number of beds filled by patients with norovirus symptoms, including children in paediatric wards, averaged 756, up 86% on the equivalent week in 2023.
There were an average of 1,390 patients in hospital beds in England each day last week who had tested positive for Covid. This is lower than the average of 2,344 patients at the equivalent point last year, and 4,969 at this stage in 2022.
“As always, the public have an important part to play in helping NHS staff over winter by, as ever, calling 999 in an emergency and using the NHS 111 service through the NHS app, online or phone, for advice on how to access the right support for non-emergency health needs,” said Prof Powis.
The NHS situation report also shows that 36% of patients arriving by ambulance at hospitals in England last week waited at least 30 minutes to be handed over to A&E teams, higher than 27% in the equivalent week last year and 31% at this point in 2022.
Sixteen per cent of ambulance handovers last week, or 14,805 patients, were delayed by more than an hour, compared with 10% at this point in 2023 and 15% in 2022.
Wes Streeting, the health secretary, said an annual winter NHS crisis had become “the norm” and this must change. “We inherited an NHS that is broken but not beaten, and staff are already working hard to tackle an increase in admissions this winter,” he said.
“For too long, an annual winter crisis has become the norm. We will deliver long-term reforms through our 10-year health plan that will create a health service that will be there for all of us all year round.
“I’d also encourage anyone who is eligible to join the over 27 million people who have already come forward for their flu, RSV and Covid jabs – it’s the best way to protect yourself this winter.”
