The data behind record pressures on Lancashire hospitals
PLUS: Concerns over fatal incidents on the motorway network
Hello and welcome to The Lancashire Lead.
Today we report on what’s happening in Lancashire’s hospitals. Over the last week, the BBC and the Guardian have reported on the rising demand for NHS emergency services with the Telegraph and Mail Online catching up on Monday.
The pressure is broadly caused by winter flu, as well as other respiratory illnesses including Covid, which all contributed to 2024 being the busiest year on record for emergency services in the UK.
That’s not necessarily something that chimes with the level of coverage and awareness around this issue. Hospitals were busier in 2024 than at the height of the pandemic in 2020 and 2021.
We’ve dug into the data, spoken to those closest to the issue and looked at unexpected sources of pressures.
‘On Good Morning Britain, they were appalled by 50 hour waits - we hit 120 hours three days ago’
By Luke Beardsworth. Additional reporting by Paul Faulkner
Hospital staff are struggling in the wake of the busiest year for emergency services on record.
That was the verdict from one nurse at Royal Preston Hospital speaking anonymously to The Lancashire Lead - and from NHS England.
Covid, Respiratory syncytial virus (RSV) and norovirus are contributing to the demand but it is flu that is the source of the majority of the pressure.
Royal Preston Hospital sits at OPEL (Operational Pressures Escalation Levels) 3 - the highest level a hospital can be at without declaring a ‘critical incident’, which is a hospital’s way of declaring it can no longer cope with demand and provide an adequate service.
But the nurse who spoke to The Lancashire Lead believes that this threshold has been crossed - as evidenced by the worst wait of over 100 hours to be assessed in the emergency department at Royal Preston Hospital.
They said: “We are struggling and the trust will not declare a critical incident as Liverpool and many others have to due to the ‘bad press’ it would generate.
“Chorley is no better. Recently when the emergency department closed at 10pm they had 26 admitted patients who has to be bedded down, some of those patients were forced to sleep in the emergency nurse practitioner's offices.”
A spokesperson for Lancashire Teaching Hospitals, which manages Royal Preston and Chorley hospitals, said that they ‘categorically’ deny that fear of coverage has influenced their decision making in regards to declaring a critical incident.
They said they monitor the pressures on all emergency departments on a regular basis and the decision remains under review.
They added: "Essential NHS services are available for anyone that needs them, and we would encourage those who require urgent medical help to continue to come forward for care as soon as possible.
“Colleagues are working incredibly hard to treat people as quickly as possible, however some people may experience longer waits after initial triage assessment while we prioritise our sickest patients.
“We are grateful to our colleagues, who go above and beyond the call of duty to ensure our patients receive the highest standards of care possible.”
The busiest year on record
Data from December 2024 showed that NHS staff experienced the busiest month on record as pressure was piled onto them, broadly due to an average 5,408 patients per day admitted to hospitals with flu.
NHS England worked to free up beds ahead of December but the government has conceded that patients continue to receive ‘unacceptable standards of care’.
The cold weather - which has seen snow fall across Lancashire to welcome in 2025 - has also been described as a contributing factor.
Professor Sir Stephen Powis, NHS National Medical Director, said: “It is clear that hospitals are under exceptional pressure at the start of this new year, with mammoth demand stemming from this ongoing cold weather snap and respiratory viruses like flu – all on the back of 2024 being the busiest year on record for A&E and ambulance teams.”
December performances at Lancashire trusts
The goal for all healthcare providers from an emergency department perspective is to admit, transfer or discharge patients within four hours of arrival.
In December 2024, 12,273 people visited Lancashire Teaching Hospitals (Royal Preston and Chorley) emergency departments and 7,665 of those met that goal.
But that leaves 4,608 people who were waiting for longer than four hours for a decision to be taken about their health.
A similar story is told at other trusts across Lancashire where demand and pressure has been equally high for emergency departments.
Staff vaccination rates
Only around a third of frontline staff in most Lancashire hospitals had received a flu vaccine prior to the recent surge in infections, according to the most recent figures.
Even fewer had had the autumn Covid booster jab – barely one in 10 in some areas – in spite of the two viruses being part of the so-called “quademic” of illness that was widely predicted to hit the NHS this winter. Hospital services have been left under severe pressure in recent weeks after that warning came to pass.
All hospital workers who have contact with patients – regardless of whether they are medics or are in non-clinical roles – were offered free flu and Covid shots from the beginning of October under the nationwide NHS vaccination programme.
Lancashire hospitals have laid on special drop-in clinics and even dispatched ‘roving’ vaccinators to tour different departments administering jabs, in order to make it as convenient as possible for staff to get some degree of protection for themselves – and their patients.
However, it seems the annual public health message delivered by the NHS – urging those eligible for vaccination to take up the offer – failed to hit home even with many of its own staff this year.
By the end of November – the latest date for which NHS England statistics are available – the proportion of frontline Lancashire hospital staff to have had a flu vaccine stood at:
The North West average was 33.6 percent. The figures do not include any staff who chose to get a vaccine via their GP or pharmacy – although that number might well be small given the convenience of the options available at their place of work.
The Joint Committee on Vaccination and Immunisation had recommended the flu jab programme begin on 3rd October so that the majority of vaccinations across eligible groups – including the hospital workforce – would be completed by the end of November.
The UK Health Security Agency said in guidance issued in the autumn that the timing would provide “optimal protection during the highest risk period” of December and January.
Across England during the first week of this month, there was an average of 5,408 patients a day in hospital with flu – almost four times higher than the same week last year. More than a dozen hospitals nationwide have declared critical incidents because of the pressures they are facing – although Lancashire’s four acute trusts have not so far been among them.
Meanwhile, an even smaller fraction of the county’s hospital workers have had the latest Covid booster jab. By the end of November, the take-up rate was:
The average across the North West was 14.9 percent.
Hospital trusts in Lancashire are continuing to make vaccinations available for staff as they seek to protect patients, as well as encouraging members of the public to be vaccinated.
The last government had planned to make the initial two-shot Covid vaccination mandatory for healthcare workers from April 2022, but dropped the plan amid fears it would lead to the loss of too many staff. But it said those working in health and social care who were unvaccinated had “a professional responsibility” to have the jabs and what was, at that time, the first booster.
Trusts are keen that people access services in the most sensible way possible and are not discouraged from attending. They have provided the advice below:
General advice
The NHS is encouraging the public to use services wisely as 111 phone services, GP practices and A&E departments see high numbers of people contacting them following the festive period.
For those with internet access www.111.nhs.uk is available to provide urgent health advice about the best options for getting the care they need. These can include getting a call back from a trained clinician or nurse, booking them an appointment in A&E, or providing advice. NHS 111 online is not available for under 5s. People looking for urgent medical help for under 5s should use the 111 phone line.
111.nhs.uk can help you with:
where to get help for your symptoms, if you’re not sure what to do
how to find general health information and advice
where to get an emergency supply of your prescribed medicine
how to get a repeat prescription
get emergency dental appointments
You should still ring 999 if you experience:
signs of a heart attack like pain like a heavy weight in the centre of your chest
signs of stroke such as your face dropping on one side
difficulty breathing
heavy bleeding that won’t stop
seizures
or sudden and rapid swelling of the eyes, lips, throat or tongue
The public can play their part by taking simple measures to stay well this winter, such as getting winter vaccines when invited to, keeping warm, staying active, looking out for others, and choosing the right service when they need help. It’s not too late to get your flu vaccine and eligible people can still book their vaccination through their GP surgery or local pharmacy. Other useful information about staying well this winter, including guidance on prevention, signposting and self-care, is available on the NHS Lancashire and South Cumbria Integrated Care Board website.
For help and advice on a range of health issues, high-street pharmacies can provide expert advice. Search online for ‘find a pharmacy’ for your nearest 24-hour or out of hours pharmacy service.
We are not currently mandating masks for all patients but do have them available and are regularly reviewing this position. The Trust has access to rapid diagnostic testing in the Emergency Department for Flu, Covid, and Norovirus and will mask/isolate patients who test positive. Patients and visitors are also reminded to ensure they regularly wash or gel their hands. Visitors displaying symptoms of Flu, Covid or Norovirus are encouraged not to visit our hospitals.
We’re working to ensure patients are seen as quickly as possible, and staff are supported as they continue to work in these challenging circumstances.
Concern over policing of Lancashire’s motorway networks after series of fatal incidents
By Robbie Macdonald
Lancashire’s elected Police and Crime Commissioner has commented on traffic patrols, road safety and action against danger-drivers following recent incidents and debates about the M65, where a number of fatal incidents have happened.
Commissioner Clive Grunshaw was contacted for comment following calls by a number of Lancashire councils for a safety review of the M65. Local authorities including Pendle have raised worries about the loss of lighting, lane designs and alleged flooding problems around concrete central barriers. Separately, retired Lancashire police officer Paul Brooks recently claimed police traffic patrols had suffered as a result of funding cuts.
The Police & Crime Commissioner is a political role decided by local elections. It is officially described as the public’s voice in policing. The commissioner is responsible for setting the strategic priorities for the police and holding the force’s Chief Constable to account.
Commenting on the M65 debate to the Local Democracy Reporting Service, Mr Grunshaw said: “Lancashire Constabulary has a road policing unit, which is dedicated to patrolling the county’s roads and dealing with offences such as speeding and drink or drug-driving, as well as attending scenes of serious and fatal collisions.
“Additionally, the force regularly carries out numerous proactive operations targeting those on our roads that put the public at risk.
“Dangerous driving comes up time and time again as a huge concern for our communities, and it is a priority to make our roads even safer for the majority of law-abiding motorists.
“I will continue to work together with the Road Safety Partnership and hold the Chief Constable to account to ensure that road policing, from our motorways to our rural areas, is working to keep people safe.”
The commissioner role came into effect in 2012 as part of nationwide changes to police force accountability by the then Conservative and Lib-Dem coalition government. It replaced the old police authorities system which typically included a number of elected political councillors and other independents, such as magistrates.
Recently in response to the M65 debate, former Lancashire police officer Paul Brooks, from Bamber Bridge, said today’s motorways are not policed properly because of police force financial pressures. And he said today’s Highways Agency officers represent ‘policing on the cheap’ with few real powers. Many speeding drivers simply ignore them, he believes.
However, he also believed the loss of lighting on the M65, ‘inadequate drainage’ and its mix of two and three-lane sections were concerns too.
Mr Brooks spoke after Pendle councillor Mick Strickland, who works for Lancashire Fire & Rescue Service and has attended M65 traffic accidents, helped gain support for a motion calling for no more lights to be removed from the M65 and investment to bring lighting back where it has been removed. Pendle Council is to contact National Highways, Lancashire County Council, the Secretary of State for Transport and local MPs about the issues.
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