This monthly publication will feature a compilation of NHS England's weekly sitreps throughout the winter period. We will monitor key activity and demand figures across the NHS, analysing key trends to better understand the pressure facing trusts this winter. Additionally, a weekly dashboard with the latest data will be available in the resources section.
Findings from our recent State of the provider sector survey highlight trust leaders' concerns about upcoming winter pressures. These weekly NHS England winter reports give us timely insight into the performance of trusts across the country.
Below, we compare the latest data with previous weeks and years, providing context to better understand the current figures.
Rising pressures from winter illnesses
So far this winter, the circulation of four illnesses (influenza, Covid-19, respiratory syncytial virus, diarrhoea and vomiting and norovirus) simultaneously have piled the pressure on already stretched health services.
The first week of NHSE winter sitrep data showed clear signs of high demand driven by winter illnesses. There was a 352% increase in general & acute (G&A) beds occupied by influenza (flu) patients and an 82% increase in the number of beds closed to diarrhoea and vomiting (D&V) and norovirus, when compared to the same period in 2023-24. There were no signs of these pressures easing in the second week of winter data, with a 70% weekly rise in flu beds occupied and a 12% weekly increase in D&V beds closed.
When triangulating NHSE sitrep data with weekly surveillance reports from UKHSA, it is unclear whether this is the worst winter yet for pressures arising from flu. The number of flu beds occupied is the highest for the second week of winter since the first publication of the measure in the 2020-21 NHSE winter sitreps (see figure 11). However, data on weekly overall flu hospital admission rates per 100,000 trust catchment population, as reported by 23 trusts in the SARI Watch sentinel surveillance by the UKHSA, suggest that flu hospitalisations are currently lower than the equivalent period in 2022-23 (see figure 29 in this report). As winter progresses, we will gain more insight into how this winter compares to those in recent years.
FIGURE 11
Average daily number of general and acute beds occupied by flu patients
The two main weekly data sources on respiratory syncytial virus (RSV) give conflicting accounts: NHSE sitrep data shows a 30% rise in the number beds closed to respiratory syncytial virus (RSV) between the first and second week of winter 2024-25. But weekly hospital admission rates for the virus, as reported by 21 trusts in the SARI Watch sentinel surveillance data by the UKHSA, fell from a record peak of 4.13 per 100,000 last week to 3.01 per 100,000 this week. This rate is also below the weekly RSV hospital admission rate for 2023-24 in the same period (3.7 per 100,000).
UKHSA weekly reporting for Covid-19 data that is comparable across winters, gives a more positive sign: the weekly hospital admission rate for Covid-19 was 1.71 per 100,000, lower than last week (1.84 per 100,000) and the lowest of the same period for any winter, post pandemic.
Frontline medical and support staff encounter the illnesses mentioned above, and others, when interacting with patients over winter, which can lead to absences. The latest data shows that in the second week of winter there were on average 53,095 staff absent each day in acute trusts. This is 2.8% higher than the first week of winter and 8% higher than the same period in 2023/24.
Trust leaders are encouraging anyone eligible for flu, Covid-19 or RSV vaccines to have their jabs as soon as possible. NHS teams have delivered over 27.7 million flu, Covid-19 and RSV vaccinations have to date this winter, but there is more to do to alleviate pressures arising from winter illnesses.
A&E, ambulance arrivals and handovers
Echoes of the record demand for A&E, highlighted in the monthly NHSE data release (see our acute section), can be heard in the first two weeks of winter sitrep data. There have been a total of 62 A&E diverts across the first two weeks of winter, twenty more than in the same period last year.
The past two weeks of winter data also underline the pressures facing the ambulance service - with over 180,000 patients arriving by ambulance in that period. This is over 12,000 more than the same period last winter and nearly 28,000 more than two years ago, highlighting the intensity of the pressures facing the service this year.
So far this winter, 68,205 hours were lost to handovers beyond 30 minutes, which is 15% higher than the two weeks last year. In the latest week, 35.8% of ambulance handovers were delayed by 30 minutes or more, down from 36.1% last week. 16.3% were delayed by 60 minutes or more, also down slightly from 16.4% last week.
FIGURE 12
Total weekly number of patients arriving by ambulance (where handover time is known)
Bed occupancy and capacity
The bed occupancy rate was 94.6% for the second week running this week, remaining above the 92% set out in the UEC recovery plan. In the second week of winter sitrep data, there were an extra 74 beds occupied on average each day than the previous week and 727 more compared to the same time last year.
The latest data shows that critical care and neonatal intensive care unit (NICU) occupancy rates were 81.2% and 69.6%, respectively, both slightly increased week on week, but were lower than the second week of winter last year. However, the paediatric intensive care unit (PICU) occupancy rate (85.2%) fell in the second week of winter and was also lower than last winter.
Discharge delays interrupt patient flow in hospital settings. In the latest week of winter data, of patients who no longer met the criteria to stay, 55.1% remained in hospital at the end of the day. This is a slight increase compared to last week (54.9%) but down from the same time last year (55.7% last year).
To interact with out winter analysis and make comparisons with the latest data to previous years, please view our winter watch dashboard.