Are Four NHS Trusts Facing Critical Incidents Due to Overwhelming Demand?

The ongoing pressures on NHS services have led to four hospital trusts in the UK declaring critical incidents, primarily due to rising flu and norovirus cases, as well as increased staff sickness. NHS Surrey Heartlands is particularly impacted, with three trusts in Surrey—Royal Surrey NHS Foundation Trust, Epsom and St Helier University Hospitals NHS Trust, and Surrey and Sussex Healthcare NHS Trust—facing significant challenges. Additionally, East Kent Hospitals University NHS Foundation Trust has also announced a critical incident at the Queen Elizabeth the Queen Mother Hospital in Margate, exacerbated by high demand and winter illnesses.

Last updated: 04 October 2023 (BST)

What’s happening now

The NHS is currently grappling with unprecedented demand as several hospital trusts declare critical incidents. This declaration allows these trusts to implement emergency measures aimed at sustaining patient safety amid overwhelming pressures. The situation is particularly dire in Surrey, where the Royal Surrey NHS Foundation Trust, Epsom and St Helier University Hospitals NHS Trust, and Surrey and Sussex Healthcare NHS Trust are struggling with complex A&E attendances and delayed discharges. In Kent, East Kent Hospitals University NHS Foundation Trust is also facing similar challenges, with the Queen Elizabeth the Queen Mother Hospital reporting extremely limited capacity due to high admission rates and ongoing winter illnesses.

Key takeaways

• Four NHS hospital trusts have declared critical incidents due to significant service pressures.
• Rising flu and norovirus cases, along with increased staff sickness, are major contributing factors.
• Non-urgent medical procedures may be rescheduled to prioritise patients with urgent clinical needs.

Timeline: how we got here

The current crisis in NHS services has been brewing over the past few months, culminating in critical incidents declared in early October 2023. Here’s a brief timeline of key developments leading up to this point:

• August 2023: Reports emerge of increasing hospital admissions due to respiratory illnesses.
• September 2023: Flu and norovirus cases begin to rise, placing additional pressure on NHS services.
• 1 October 2023: NHS Surrey Heartlands announces significant pressure on local hospital trusts.
• 4 October 2023: Four NHS hospital trusts declare critical incidents in response to overwhelming demands.

What’s new vs what’s known

New today/this week

This week, the declaration of critical incidents by the four NHS hospital trusts is the most significant development in response to the increased demand. Trusts can now implement emergency measures to manage patient care more effectively.

What was already established

Prior to these declarations, NHS trusts were already struggling with rising patient numbers exacerbated by seasonal illnesses and staff shortages. The ongoing issues with patient discharge and A&E congestion have been longstanding concerns within the NHS framework.

Impact for the UK

Consumers and households

The impact on consumers is immediate, with potential delays in non-urgent medical procedures and longer wait times at A&E. Patients are advised to seek alternative healthcare services for non-critical conditions to alleviate pressure on emergency departments.

Businesses and jobs

For NHS staff, the pressure to manage increased patient loads may lead to burnout and further absenteeism. Businesses associated with healthcare supply chains may also experience disruptions as hospitals prioritise urgent care over routine services.

Policy and regulation

In response to the critical incidents, policymakers may need to reassess resource allocations and staffing levels within the NHS. Upcoming consultations regarding health service funding and staffing strategies could be expected in the following weeks.

Numbers that matter

• Four NHS trusts have declared critical incidents, reflecting a significant rise in pressure.
• Winter illnesses have led to increased admissions, with hospitals reporting full bed capacities.
• Attendance at emergency departments is at an "exceptionally high" level, leading to long waits for non-urgent cases.

Definitions and jargon buster

• Critical Incident: A situation that requires emergency response measures due to significant service pressures.
• NHS: National Health Service, the publicly funded healthcare system in the UK.
• A&E: Accident and Emergency, the department in hospitals that deals with urgent medical cases.

How to think about the next steps

Near term (0–4 weeks)

In the immediate future, NHS trusts will continue to manage critical incidents, which may involve rescheduling non-urgent operations. Patients should prepare for possible delays in appointments and treatment.

Medium term (1–6 months)

Over the next few months, the NHS will likely reassess its resource allocation and staffing strategies to better cope with seasonal pressures. An increase in funding or staffing may be necessary to address the ongoing issues.

Signals to watch

• Monitoring hospital bed occupancy rates and A&E wait times can indicate how well the NHS is managing current pressures.
• Updates on patient discharge times will also be crucial in understanding the effectiveness of NHS responses.

Practical guidance

Do

• Attend your scheduled appointments unless contacted by the hospital.
• Use alternative healthcare services for non-life-threatening conditions, such as local pharmacies or urgent care clinics.

Don’t

• Do not attend A&E for non-urgent health issues, as this may prolong wait times for those in need of urgent care.
• Avoid self-diagnosing or delaying medical treatment if you are experiencing severe symptoms.

Checklist

• Check for updates on your medical appointments.
• Know alternative healthcare services available in your area.
• Be aware of flu and norovirus symptoms, and seek advice if needed.
• Monitor local health announcements regarding NHS service updates.

Risks, caveats, and uncertainties

While the current situation in the NHS reflects immediate service pressures, the long-term implications remain uncertain. The dynamics of patient demand, staffing levels, and seasonal illness trends could evolve rapidly. It is essential to approach the situation with caution, as ongoing developments may lead to further changes in NHS operations.

Bottom line

The declaration of critical incidents across four NHS trusts highlights the escalating pressures facing healthcare services in the UK. With rising flu and norovirus cases, alongside staffing challenges, patients may experience delays in non-urgent care. It is crucial to stay informed about service updates and consider alternative healthcare options where possible.

FAQs

What does it mean when a hospital declares a critical incident?

When a hospital declares a critical incident, it indicates that they are facing significant pressures and can implement emergency measures to ensure patient safety and care continuity.

How does this affect my scheduled medical appointment?

Your scheduled medical appointment may be rescheduled if it is deemed non-urgent. It is advised to attend unless you are contacted by the hospital regarding changes.

What should I do if I have a non-urgent medical issue?

If you have a non-urgent medical issue, consider using alternative services such as local pharmacies or urgent care clinics to avoid long waits at A&E.