The NHS in England faces critical challenges during winter, including increased pressures on accident and emergency (A&E) departments and ambulance services. We’ll discuss the acute pressures experienced in winter 2024/25, including record A&E waits and ambulance delays. The episode highlights strategies to address these issues, such as prevention, increased capacity, and workforce support. Finally, we delve into the government's plans and NHS guidance for winter 2025/26, aiming for significant improvements in urgent and emergency care.

Key Takeaways

• Persistent Winter Strain: Cold weather increases health risks and the spread of viruses (flu, RSV, norovirus, COVID-19), leading to significant pressure on the NHS, especially A&E and ambulance services.
• Acute 2024/25 Challenges: Winter 2024/25 saw increased A&E diverts, a record 11% of patients waiting over 12 hours for A&E admission in January 2025, and 32% of ambulance handovers taking over 30 minutes. Seasonal viruses occupied almost 600,000 hospital beds.
• Core Causes of Pressure: Pressures stem from increased demand for complex care, consistently high bed occupancy rates (exceeding recommended safety levels since at least 2010), and delayed patient discharges due to a lack of social care capacity.
• Addressing Pressures: Efforts include preventing illness through vaccinations and guidance, increasing hospital bed and staff capacity, and supporting the wellbeing of the NHS workforce.
• 2025/26 Strategic Plans: The NHS Urgent and Emergency Care Plan for 2025/26 aims to reduce ambulance wait times, ensure 78% of A&E patients are seen within 4 hours, lower 12-hour A&E waits to under 10%, and tackle delayed discharges. Integrated care boards (ICBs) and Trusts will stress-test their plans in September 2025.
• A&E Waits and Mortality: Research indicates a statistical association between longer waits in A&E and a higher risk of 30-day post-discharge mortality, though it's not definitively proven as a direct cause.

Source: NHS winter preparedness
Research Briefing
Published Friday, 15 August, 2025

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