The Recurrent Winter ‘Flu Problem

Winter ‘flu again

In my blog four weeks ago I indicated my concern about the usual winter blues brought on by the annual ‘flu outbreak. My concern was piqued by the very early onset of the epidemic and by the steep rise in cases, both in the community and in the consequent admissions to hospital.

My New Year message two weeks ago interrupted my intention to talk about it last time – and now the epidemic seems to have peaked, the number of cases and the burden on the NHS is easing but may see a resurgence. Phew!

Why so much concern?

Once more the inability of the NHS to cope with an entirely predictable annual threat has been laid bare. Staffing shortages, budget cuts, and a general lack of resources have already stretched the system thin. Flu, which disproportionately affects the elderly and those with pre-existing health conditions, has further burdened an already overwhelmed health service. Each year’s strain of flu leads to an entirely predictable surge in cases which the NHS is ill-prepared to cope with.

Elderly patients, who make up the largest proportion of flu-related hospitalizations, are particularly vulnerable. Many suffer from weakened immune systems, chronic health problems, and reduced mobility, which complicates both treatment and recovery. With the flu virus spreading quickly through care homes and hospitals, healthcare professionals are finding it increasingly difficult to manage the high influx of patients.

The cascade of events is best understood backwards.

1. The community care system, including care homes and domestic care givers, is full.
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2. Therefore frail elderly people in hospital are remaining as in-patients way beyond the time they need inpatient care. About one in seven inpatients no longer need hospital treatment.
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3. Therefore the wards are full – no beds are available for new acute admissions.
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4. Therefore those who need a hospital bed are being nursed in corridors, mainly in A & E departments. The increased risk to the patient is obvious.
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5. Therefore the A & E space is also full and new patients cannot be admitted. Again the increased risk to the patient is obvious.
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6. Therefore patients waiting to be seen are stacked up in a queue of ambulances outside the Department, sometimes for many hours. Again the increased risk to the patient is obvious.
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7. Therefore the wait for an ambulance to attend a needy patient is  prolonged, sometimes by many hours, again sometimes for many hours. Again the increased risk to the patient is obvious.
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8. Therefore many patients are dying unnecessarily.

The standard response

Here are the usual “solutions” suggested by our policy makers (aka politicians):

1. Increased Investment in Community Care: The ability to care for frail, elderly individuals in the community is essential. A greater focus on expanding home care services, improving access to community health professionals, and supporting local care providers will help reduce the burden on hospitals and ensure that vulnerable patients receive the support they need.

2.  Adequate Staffing and Resources: Ensuring that the NHS is adequately staffed is critical in preventing service disruptions during peak periods. Increased funding for training, recruitment, and retention of healthcare workers, especially in ambulance services and emergency departments, will help improve response times and patient care.

3. Improved Infrastructure: Addressing the lack of hospital beds and ensuring that emergency departments are adequately resourced will improve patient flow and reduce delays in treatment. This could also help to alleviate the problem of delayed hospital discharges.

What about prevention?

What indeed? It seldom receives any attention at all. But the underlying cause of all these problems, the deplorable state of the poor health of our elderly population, is at the root of the problem – and it is preventable. The great majority of people who become acutely ill at any time and particularly in the winter months, are the frail elderly and FRAILTY IS PREVENTABLE!

Next time I will look at some more implications of frailty and how they can be tackled.