Winter pressures: what's going on behind the scenes?

In this latest analysis from QualityWatch we track A&E performance across 29 different indicators over the past five years (from Spring 2010 to autumn 2015) to shine a light on the pressure hospital services experience in winter.


Published: 11/02/2016

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Starting in early December each year, so-called NHS ‘winter pressures’ make the headlines. Attention invariably tends to be focused solely on the performance of A&E units. We examine whether the relentless focus on the four-hour A&E target for hospitals gives the full picture of pressures on NHS trusts. 

Winter pressures: what’s going on behind the scenes? finds that pressure normally seen during the winter months is now increasingly visible at other times of the year. The analysis also highlights that, in some areas, the NHS has been coping well with winter pressures. 

Other key findings include the following:

  • A&E attendances each year are increasing – seven per cent over the last five years. 
  • While the trend in the number of people attending A&E units each year is increasing, fewer people attend during winter compared to the rest of the year. But of those who do attend there is a larger proportion of older people attending and a larger proportion of people requiring an emergency admission to hospital.
  • The pressure on primary and community services in winter is largely unquantifiable at a national level because of a lack of available data.

More about QualityWatch: 

QualityWatch is a major research programme from the Nuffield Trust and the Health Foundation that provides independent scrutiny into how the quality of health and social care is changing over time. For further resources and analysis from this programme of work, visit the dedicated QualityWatch website.

Suggested citation

Fisher E and Dorning H (2016) Winter pressures: what's going on behind the scenes? QualityWatch briefing. Nuffield Trust and the Health Foundation.