How is your local NHS coping under winter pressures?
Pressure on hospitals is particularly high this winter, with more than a dozen declaring critical incidents in recent days.
Hospitals struggle every winter with additional pressures due to the impact of cold weather, but the early arrival of flu this season and high volume of cases meant Christmas and New Year’s weeks were even busier than usual.
There are currently at least 20 hospitals that have declared critical incidents in England, although this is a fast-moving picture, and some trusts will go into critical incident for as little as half an hour.
The latest NHS winter situation reports give a more detailed look at the level of pressure experienced by individual trusts, including those with the worst ambulance handover delays and highest levels of flu patients.
Ambulance handover delays
When a patient arrives at a hospital in an ambulance, clinical guidelines suggest that it should take no longer than 15 minutes to transfer them into emergency care.
It is now common for handovers to regularly exceed this timeframe, however, when emergency departments are overcrowded and lack the capacity to keep up with new patient arrivals.
This is risky for patients because it delays their assessment and treatment by clinicians, and also reduces the availability of ambulances to respond to new incidents.
The trust with the longest delays was University Hospitals Plymouth, with an average handover time of three hours and 33 minutes over the week – two hours and 40 minutes longer than the average for England. It also recorded the longest average handover times for a single day, at five hours and 14 minutes on New Year’s Day.
Use the table below to search for local ambulance handover times:
On 7 January, University Hospitals Plymouth declared a critical incident at Derriford Hospital due to “significant and rising demand for hospital care”, though this has since been stood down.
The Shrewsbury and Telford Hospital Trust had an average ambulance handover time of three hours and 15 minutes, increasing by more than an hour from one hour and 51 minutes the week before.
In Royal Cornwall Hospitals NHS Trust, 83% of handovers took more than 30 minutes, the highest share among areas dealing with more than five ambulance arrivals per day.
This area also recently declared and then stood down a critical incident.
In total across England, 43 trusts out of 127 had average handover times of more than an hour, while nine areas had average handover times of more than two hours.
Flu
This winter’s flu wave arrived earlier than usual and has hit health services hard.
Over New Year’s week, there were 5,407 flu patients in hospitals in England on average each day, more than three times higher than during the same week last year and increasing by 20% from the week before.
The worst impacted trusts were Northumbria Healthcare and University Hospitals Birmingham, with 15% and 13% of all available beds occupied by flu patients respectively in the latest week.
Wirral University Teaching Hospital NHS Foundation Trust had among the biggest increase in flu patients from the previous week, more than doubling from 18 to 42 patients per day on average.
Use the table below to search for local flu hospitalisations:
There are some indications that flu activity may have now peaked, with national flu surveillance showing a decrease in positive flu tests in the latest week, though activity remains at high levels.
Bed occupancy
Current NHS guidance is that a maximum of 92% of hospital beds should be occupied to reduce negative risks associated with overfilled beds.
These risks include the impact on patient flow resulting from it being more difficult to find beds for patients, and negative impacts on performance and waiting times, as well as being linked to increased infection rates.
In the week to 5 January, 92.8% of 102,546 open hospital beds were available each day on average, not far off the recommended level.
However, bed occupancy was very high in some trusts, with more than 95% of beds occupied in 43 trusts on average over the week.
The trust with the highest rate of bed occupancy was Wye Valley NHS Trust, with 99.9% of 332 beds occupied on average throughout the week.
There was only one day when beds weren’t fully occupied, on 3 January, when two beds of 322 were available.
Use the table below to search for local bed occupancy:
Kettering General Hospital NHS Trust recorded bed occupancy of 98.5% over the week. This trust declared a critical incident on 8 January.
Part of the problem for bed availability is prolonged hospital stays – also known as bed-blocking.
This is often linked to pressures in other parts of the health and social care system, for example when patients can’t be discharged to appropriate social care providers even though they are ready to leave hospital.
Just under half of beds occupied by patients in English hospitals last week were occupied by long-stay patients who had been there for seven or more days.
In seven trusts, at least three in five beds were occupied by long-stay patients, while in Barking, Havering and Redbridge University Hospitals NHS Trust the figure was more than four in five beds.
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England star Jess Carter says she has been the victim of racist abuse online during the UEFA Women’s Euros in Switzerland.
The Lionesses defender, who has 49 England caps, said she will be “taking a step back from social media and leaving it to a team to deal with”.
In an Instagram post, the 27-year-old player said: “From the start of the tournament, I have experienced a lot of racial abuse. Whilst I feel every fan is entitled to their opinion on performance and result, I don’t agree or think it’s ok to target someone’s appearance or race.”
Jess Carter. Pic: PA
Carter said she was stepping back from social media to “protect myself in a bid to keep my focus on helping the team anyway I can”.
She added: “Hopefully speaking out will make the people writing this abuse think twice so that others won’t have to deal with it.”
Carter also said that England have made some “historic changes with the Lionesses squad” that she was “so proud” of, and she hopes that by speaking out about racial abuse “it will make another positive change for all”.
‘Abhorrent abuse’
The Football Association leadership has condemned the “abhorrent abuse” against Carter and has contacted UK police about it.
FA chief executive Mark Bullingham said in a statement: “Our priority is Jess and giving her all the support she needs. We strongly condemn those responsible for this disgusting racism.
“As soon as we were made aware of the racist abuse Jess received, we immediately contacted UK police. They are in touch with the relevant social media platform, and we are working with police to ensure those responsible for this hate crime are brought to justice.”
Carter during a training session in Switzerland. Pic: PA
The Lionesses said in a statement: “We stand with Jess and all Lionesses players past and present who have suffered racism.
“No one should have to endure such vile abuse, be that in football or any walk of life.”
They added: “Those behind this online poison must be held accountable.”
Anger and sadness
England teammate Lucy Bronze said there was “anger” and “sadness” among the squad following the abuse.
Bronze said: “I think we all know that any player of colour that’s played for England has probably gone through racist abuse. That’s a sad fact.”
She told Sky News’ sports correspondent Rob Harris that social media platforms need to be held more accountable.
Bronze added: “People need to be held accountable for their actions, whether it’s in-person or online. The abuse is not okay. Racism is not okay.”
Read more from Sky News:
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The prime minister said on X that there was “no place for racism in football or anywhere in society”.
Sir Keir Starmer added: “I stand with Jess, the Lionesses, and any players who have suffered racism, on and off the pitch.”
Carter has started all four of England’s games at the tournament.
The defending champions face Italy on Tuesday night in Geneva in the Euros semi-finals. If they win and reach the final, they will play either Germany or Spain, who face each other on Wednesday.
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The Lionesses also said that until now, they have chosen to take the knee before matches.
“It is clear we and football need to find another way to tackle racism,” they said.
England won’t be taking the knee before semi-final
The Lionesses said they have agreed as a squad to remain standing before kick-off in the match against Italy.
“We hope the game can come together to see what more can be done.”
Kneeling, a symbolic anti-racism gesture, came to prominence in 2016 when NFL player Colin Kaepernick knelt in protest during the United States national anthem and became more widespread during the Black Lives Matter movement.
As head of football’s anti-racism body, there was dread for Sanjay Bhandari watching England’s Women’s Euros quarter-final with Sweden.
But that’s, grimly, how it always is. Concerned that black players will be singled out for blame. Not with a legitimate critique of their performances, but with toxicity and racism.
And now Kick It Out is working with the Football Association to support Jess Carter after the England defender spoke out over the abuse she has been targeted with throughout the Women’s European Championship.
The players want social media firms to do more, but Mr Bhandari, the Kick It Out chairman, is concerned by their limited approach to the scourge of online hate.
Jess Carter says she has been the target of racist abuse. Pic: PA
“The social media companies need to do far more,” he told Sky News. “They’ve actually gone backwards over the last four or five years, not forwards. It’s got worse on social media, not better.
“And they need to provide us with the tools to help keep us safe and to remove some of this toxicity from the platforms. They’re just not doing enough.
“I would say that X is the worst. It has become no-holds-barred.
“And with Instagram, it is much more in the direct messaging, and I think there needs to be much more done there to protect people from those messages.”
Meta, which owns Instagram, did not reply to a request for comment.
There was no response from an email sent to X’s press email address.
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‘People need to be held accountable’ after Euros racism
LinkedIn indicated that X’s UK managing director Jonathan Lewis’s account had seen a request for comment, but there was no response.
On Friday, Mr Lewis and Premier League club Burnley were celebrating a new partnership in an announcement that made no mention of the abuse that many players across the world face on X.
The hope is that the Online Safety Act will lead to social media firms implementing the safety tools required of them.
Mr Bhandari said: “They have to be enforced by law enforcement against individual perpetrators, and also the regulatory parts need to be forced against the social media companies to force them to do the things that they need to do.”
Grimly familiar situation
The FA reported the abuse suffered by Carter to police, and the hope is for speedy action because this is a grimly familiar situation.
After the men’s Euros final in 2021, Marcus Rashford, Jadon Sancho and Bukayo Saka were racially abused after missing penalties in the shootout defeat to Italy.
Bukayo Saka was among the England players targeted after missing penalties in the Euros final. Pic: Reuters
While players have been taking a knee against racism in men’s and women’s games, the Lionesses feel that is no longer enough at these Euros.
They will stand instead before the semi-final with Italy because they say a new approach is needed to tackle racism.
Read more from Sky News:
Lionesses ‘very optimistic’ Williamson will be fit for semi-final
Team went from sloppy to celebratory in nerve-shredding quarters
Carter didn’t just face racism around the quarter-final that England won on penalties after fighting back from 2-0 down against Sweden here in Zurich.
She has been subjected to abuse throughout the Euros.
“I’m really feeling for Jess and what’s sad is that this is shocking, but not surprising,” Mr Bhandari said.
“I watch every England game, at every tournament, with the fear that after the match, there’s going to be abuse of a black player using the spurious basis of performance as an excuse to justify unjustifiable racism. All racism is unjustifiable.
“The fact that someone’s had a good or bad game in your opinion does not justify that kind of racist abuse.”
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