England has recorded the highest early‑winter level of hospital flu patients since comparable reporting began, with an average of 1,717 people in beds each day last week, including 69 in critical care. That is 56% higher than the same week in 2024 and well above 2023 and 2022 levels, according to the first NHS England winter situation report of the season.
NHS England’s national clinical director for urgent and emergency care, Professor Julian Redhead, said cases are “incredibly high” for the time of year and that there is “no peak in sight”, warning that rising admissions could stretch staff close to breaking point. The service is urging the public to use NHS 111 online or by phone for non‑life‑threatening problems and to reserve A&E for emergencies.
The timing collides with new industrial action. The British Medical Association has confirmed resident doctors (formerly junior doctors) in England will strike from 07:00 on 17 December to 07:00 on 22 December, citing the government’s failure to make a credible offer on jobs and pay. NHS England’s chief executive, Sir James Mackey, told the board on 4 December that the planned action has generated “anger, frustration and exasperation” among staff working to keep services safe through winter.
NHS data also indicates this year’s flu season began earlier than usual, contributing to increasing pressure on hospital capacity ahead of Christmas. While flu occupancy has surged, the first sitrep shows norovirus and Covid bed numbers are lower than at the same point last year, a reminder that overall pressure is driven by a shifting mix of seasonal viruses.
Alongside the warning on flu, NHS England has published analysis of last winter’s demand showing 200,028 A&E attendances between 1 November 2024 and 28 February 2025 for conditions manageable elsewhere, including sore throat (96,998), earache (83,705), nasal congestion (6,382), itching skin (8,669), ingrowing nails (3,890) and hiccups (384). Patients are being asked to consider pharmacies, GPs and NHS 111 for such presentations.
For day‑to‑day access, NHS leaders point to Pharmacy First, launched nationally on 31 January 2024, which enables community pharmacists to complete episodes of care for seven common conditions under defined clinical pathways. The programme is intended to reduce avoidable A&E use and free GP appointments while maintaining clear escalation routes for red‑flag symptoms.
The chief medical officer has underscored the risk profile for older adults. In his 2025 annual report, Professor Sir Chris Whitty highlighted that infections account for the majority of infection‑related deaths in older age and called for more systematic prevention and management – including vaccination and prompt treatment – to reduce avoidable harm.
Service leaders stress that structural capacity measures remain essential. Under the urgent and emergency care recovery plan, the NHS committed to 5,000 extra permanent beds, 800 additional ambulances and expansion to at least 10,000 virtual ward beds to support winter resilience and improve patient flow. These measures are now embedded across systems but will be tested by continued high flu admissions.
Front‑line clinicians caution against focusing solely on minor attendances. The Society for Acute Medicine reports almost 452,600 twelve‑hour waits in emergency departments between January and October 2025 and describes these delays as “completely unacceptable”, reflecting wider issues of capacity, flow and workforce that undermine privacy and dignity.
The operational ask for the public is straightforward. Use NHS 111 online or by phone for urgent, non‑life‑threatening needs; access community pharmacy and general practice for minor illness; and attend A&E or call 999 only for life‑threatening emergencies. For providers, the immediate task is to sustain winter plans through the strike period while protecting critical care, discharge pathways and elective recovery where safe to do so.