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8 charts showing the pressure on England’s NHS - as Boris Johnson announces lifting of Plan B restrictions

NHS staff are in for “many tough months ahead,” NHS national director Professor Stephen Powis has said

<p>How is the NHS coping this winter?</p>

How is the NHS coping this winter?

NHS doctors, nurses, paramedics and other staff are continuing to feel the pressure this winter, despite a drop in the number of Covid patients in hospital.

Following a rapid rise in admissions of people with Covid in the second half of December, both the number of patients in hospital and new admissions have begun to fall.

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But staff are having to juggle caring for Covid patients in wards that remain dangerously busy, a logistical challenge when it comes to infection control, according to NHS England’s weekly winter pressure report.

And tens of thousands of NHS workers are still absent from work – although these figures have also fallen significantly in the latest week.

NHS national medical director Professor Stephen Powis said the numbers were “going in the right direction” but that staff “still have many tough months ahead”.

“The number of people in hospital for both Covid and non-Covid care remains high, and arrivals at A&E via ambulance increased by more than 2,000, even as the largest and fastest vaccination programme in NHS history is boosting the nation and helping to protect people from the virus,” he added.

“Despite everything they have to manage, hardworking staff continue to provide routine care to patients, including rising numbers of routine checks, and they are determined to do more.”

Here are eight charts that show what the current situation is across England’s hospitals.

Bed occupancy breaching ‘safe’ limits

Hospitals were still potentially dangerously busy in the latest week, with almost nine in 10 NHS trusts recording average occupancy levels that breached what is normally considered a safe limit.

In the week to 16 January, 93.2% of general and acute beds for adults were occupied on average, according to NHS England’s weekly winter situation report.

That was a very slight rise on the previous week, when occupancy was at 93.1%, showing pressure on wards is not letting up even as Covid restrictions are set to be lifted in England.

General and acute beds are for people admitted from A&E, by their GP, or who are recovering post surgery. It excludes beds in intensive care, maternity, and mental health wards.

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Hospitals are considered to be too busy if more than 85% of beds are occupied. After this, patient care is thought to be compromised. In the last week, 121 of the 135 hospital trusts in England (88.3%) recorded average occupancy levels above this threshold, one more than the previous week.

Seven ran out of beds completely, hitting 100% occupancy, on at least one occasion, although that was down on 12 trusts the previous week.

One hospital, the George Eliot Hospital Trust in Nuneaton, was completely out of beds on six out of seven days.

High occupancy rates can lead to bed shortages and make it difficult to find the optimum bed for a patient’s needs, contributing to waiting time backlogs and delays in A&E.

There is also evidence it can lead to an increase in hospital acquired infections and other “avoidable adverse events”, according to a review by the National Institute for Clinical Excellence (NICE).

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Because of enhanced infection control measures and the need to treat Covid and non-Covid patients separately, hospitals are also likely to feel the strain at lower occupancy levels than previous years, NHS England said.

How many Covid patients are in hospital?

There has been a decrease in the number of Covid cases hospitals are dealing with.

There were 15,742 people of all ages in hospital with Covid as of 19 January, according to the UK Covid dashboard.

That has come down from 16,881 on 12 January but is still more than two-and-a-half times more than there were at the start of December (5,829), and over 3,000 more than at the start of January (12,615).

The data counts all Covid-positive patients, regardless of whether Covid was the primary reason for them needing hospital care.

New daily admissions rose for three consecutive days to 17 January, the latest available data. But the weekly average of admissions stood at 12,870 on 17 January, down from 14,072 on 10 January.

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What proportion of beds are taken up by Covid patients?

Weekly data from NHS England shows what proportion of available beds are occupied by Covid patients and other patients, and how many are available.

Even if a patient is not primarily in hospital because of Covid, a high number of patients with the virus still piles pressure on the health service as they have to be separated from other patients – not an easy task, when overall occupancy levels are so high.

In the week to 18 January an average of 13,477 (14.9%) general and acute beds for adults were occupied by Covid patients each day, up from 12,912 (14.3%) a week earlier.

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When it comes to adult critical care wards the number of beds occupied by Covid patients has been falling steadily.

In the week to 18 January Covid patients took up an average of 691 beds each day (16.3%), down from 793 (18.7%) the week before.

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Staff absences are finally on the decline

After weeks of staggering increases in the number of staff off due to Covid, absences are finally on the decline at hospitals.

NHS England data shows 77,217 staff members at acute hospital trusts were off every day on average in the week to 16 January, down by 12.8% on the previous week.

This was driven by a big drop in Covid absences, with the number of staff off with the virus or forced to isolate because of it down by 22.3% during the week.

There was a daily average of 35,555 staff off because of Covid last week compared to 45,736 the week before, the lowest weekly average since the seven days ending 1 January.

This does not include paramedic absences, staff off from non-acute trusts such as for community, mental health or learning disability care, or GP staff, who are not employed by NHS trusts.

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Paramedics facing record demand

Weekly data on ambulance arrivals at A&E shows there has been a decrease in handover delays.

A handover delay is when paramedics are stuck with a patient, unable to transfer them into the care of hospital staff.

Handovers are supposed to happen within 15 minutes. NHS England data however only reveals when patients waited 30 minutes or more.

In the week to 16 January, 9,351 patients (11.2%) were left waiting between 30 and 60 minutes to be handed over while 5,610 (6.7%) waited over an hour.

This was down from 12.8% and 9.8% respectively the week before, but still much worse than it had been during the two weeks from 13 to 26 December.

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Separate data shows paramedics were called to a record number of life-threatening incidents last month.

Monthly NHS England figures show paramedics attended 82,361 Category 1 calls in December. That was up by 34.8% on December 2020 when there were 61,091, and averages out at one every 33 seconds.

Category 1 incidents are the most serious, where an immediate response is needed to a life threatening condition such as a heart attack.

However, other kinds of less serious incidents were down on last year’s levels, meaning the overall number of callouts fell from 647,846 in December 2020 to 605,673 this year.

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