Thousands of people are going to hospital with severe flu – and a Greater Manchester GP has explained the reason.
The NHS has been warning of a ‘tidal wave’ of flu, Covid-19, RSV and norovirus piling pressure on hospitals across the country – dubbed a ‘quad-demic’. Health service chiefs have said it could be seeing the worst ever winter flu season, with Greater Manchester seeing almost three times the number of people in hospital with the infection compared to this time last year.
Greater Manchester GP Dr Helen Wall told the Manchester Evening News how a combination of low vaccine uptake – and the reality that the vaccine does not cover all of possible strains of flu – has led to a huge spike in cases. “Flu is changing constantly, it evolves so frequently. Every year we try to match the strains, but we don’t always get it right or get every single strain,” the Bolton doctor said.
“There’s still potential for you to get flu and be really quite unwell.”
Even so, the number of people taking advantage of getting some protection from a flu jab are down – and the future of flu is difficult to predict over the coming weeks. “Hitting the 95pc of people vaccinated mark – which the World Health Organisation sets out for herd immunity – is hard. Uptake on the flu vaccine is never where we’d like it to be,” Dr Wall added.
“The difficulty has been selling it to people who are clinically at risk but under 65, who have been slow to come forward for it, if at all. Uptake among over 65s has been slightly down, but only by a few percent, not drastically. Care home uptake has been good.
“We started the flu programme slightly later because we set off with RSV vaccinations first, so there has been a bit of a lag. But now, we’re not really sure what we expect to see.”
An average of 4,469 patients were in England’s hospitals with flu in the week ending Sunday, December 29, according to the latest official figures. That’s five-times as many cases as the same time last year when there were an average of 942 in hospital with flu – and is more than double the average at the same time in 2022 when there were 2,088 flu patients in hospital.
Greater Manchester is also experiencing far more cases this year. There were an average of 197.3 patients with flu in the region’s hospital beds in the week ending December 29.
That’s up from 150.7 a week earlier and is almost three times as many as the same time last year when there was an average of 69.4. In 2022 however, there were an average of 406.4 patients in hospital with flu over the same seven day period.
Dr Helen Wall
Cases of flu are much higher than last year and, Dr Wall says, ‘the concern is that it’s rising and we don’t know where it’s going to stop’.
“In the first week of December, we saw a 360% rise in hospital admissions for flu compared to last year. That’s a huge increase,” explained the experienced GP.
“We always see a spike in winter, so we expect that. But we’ve had much higher rates, and much earlier on in the year. If that had continued alongside RSV, Covid, and norovirus, we’d be in a really difficult place.
“We are in a pressured place, but Covid and RSV have tailed off. Flu is still causing us problems though.”
Staff in the region’s hospitals have spoken out in recent weeks about ‘severe overcrowding’, and severe shortages of beds. In the days before Christmas, high-level health sources told the Manchester Evening News of standing room only in the region’s A&Es, waits of more than 36 hours for a bed, frail patients breaking limbs, and elderly people in their 80s and 90s spending hours lying on trolleys in corridors.
Multiple anonymous accounts painted a bleak picture of what that looks like on the frontline. Staff have come forward with stories of ‘extreme overcrowding’, where emergency departments have been filled with as many as 180 people.
Data has shown that hundreds of patients in Greater Manchester were stuck in ambulances for more than an hour, waiting to be admitted to scarce hospital beds over Christmas in Greater Manchester. One in every 14 of those arriving to hospital by ambulance during the festive season had to wait over an hour before being admitted to both emergency and non-emergency departments, largely because of a lack of beds to give them.
There are also hundreds of patients who are medically well enough to go home, but cannot be discharged because there is no care available for when they leave the ward. A total of 859 patients in Greater Manchester hospital beds were deemed well enough to go home on December 29. Only 189 were discharged though (22%), meaning that 78% of people deemed well enough to go home were left to take up hospital beds.
It’s an ‘exit block’, say hospital staff, as people who are medically fit enough for discharge are left languishing in desperately-needed beds by an underfunded social care system that has no more capacity.
Dr Helen is a GP partner in Bolton
(Image: Dr Helen Wall)
Dr Wall fears the rise in flu cases might only continue. She said: “There’s been a spike in hospitalisations by 5,000 people a week, which causes so many knock-on effects. If beds are being taken up by flu, operations get cancelled.
“And we can’t get people out of hospital, it backs up into primary care. It creates a huge flow issue.
“At this time of year, there are a lot of respiratory problems that come up in primary care, and there’s pressure across the whole system. 111, ambulance callouts – there’s a whole range of knock-ons.
“Greater Manchester’s hospitals are coping ok, we’re holding our own. But we don’t know how far the flu will go and at what point it will peak.
“If we peak this week, we’re coping. If it’s going to carry on getting higher and higher, that’s the worry people are facing. And there’s no way of knowing.”
Colin Scales, deputy chief executive at NHS Greater Manchester, said: “Demand for NHS services is always higher in January, with a significant increase in illnesses such as flu, respiratory infections, and other winter-related conditions. These pressures are expected and we plan for them to ensure that the NHS is prepared with staff working hard to ensure that patients receive the care they need.
“Across Greater Manchester, the NHS is working with local councils and partners in the community to quickly and safely discharge patients who no longer need to be in hospital, ensuring beds are available for those requiring urgent care. We are also working alongside the North West Ambulance Service to manage delays and speed up patient transfers. All steps are being taken to ensure patients receive the care they need promptly and safely.
“We are committed to providing safe, high-quality care, and our dedicated staff are working hard to support patients during this challenging period. Please follow NHS guidance on where to seek help to ensure we can continue delivering the best care possible to those who need it most. NHS 111 can help by providing expert advice and guidance, directing people to the most appropriate care based on their needs.”