System under pressure

The NHS is facing unsustainable pressures, with record demand for urgent and emergency care, high rates of flu and COVID-19 and rising bed occupancy.
An NHS sign in a car park.

Healthcare leaders in England have warned that pressures on NHS staff are becoming unbearable.

The combined effects of high rates of flu and COVID-19, ongoing issues with delayed hospital discharges, over 130,000 NHS vacancies, lack of capital investment and record waiting lists mean that all parts of the service – including primary, community and mental health care – are under huge strain.

This section brings together our analysis on what accounts for these pressures, how they are being experienced across the system, and how organisations, systems and staff are rising to the challenge.

Featured

Ambulance in winter
Article

Analysis: NHS performance leading into winter

A look at whether the NHS is in a better position going into this winter than in previous years.

3 December 2024
An empty hospital bed.
Article

Analysis: what does the urgent and emergency care sitrep data 2022/23 tell us?

Analysis on why this winter's urgent and emergency care was more challenging than previous winters and possible impact on the NHS's overall recovery. 

26 June 2023
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Analysis

Ambulance in winter
Article

Analysis: NHS performance leading into winter

A look at whether the NHS is in a better position going into this winter than in previous years.

An empty hospital bed.
Article

Analysis: what does the urgent and emergency care sitrep data 2022/23 tell us?

Analysis on why this winter's urgent and emergency care was more challenging than previous winters and possible impact on the NHS's overall recovery. 

26 June 2023
A floor-level view of a hospital ward.
Article

78-week waiters: the story so far

The 78-week target may not have been met yet, but systems have made huge progress to bring the number down towards 10,000.

12 May 2023
A seating area in a hospital corridor.
Article

Insight into the target to reduce 78-week waiters to zero

Systems have been asked to eliminate waits of over 78 weeks by April. We look at the progress so far and what’s needed to reduce the cohort to zero.

24 January 2023
A hospital corridor.
Article

How does the data going into this winter compare to previous winters?

The first winter sitrep shows pressures starting earlier and performance in a worse place than previous winters already.

30 November 2022
A hospital corridor
Article

Analysis: The state of the elective recovery in numbers

We look at the current level of elective performance nationally and the pressures resulting in missed targets.

14 October 2022
Emergency care entrance in the snow.
Article

What the latest data tells us about NHS England’s six key metrics for winter

A look at the current level of performance against NHS England’s six key metrics for integrated care boards.

NHS worker examining young patient
Article

What the latest data tells us about progress against targets

Following the launch of June’s performance statistics, we look at how performance against a number of key targets look, both current and future.

17 June 2022
A row of ambulances outside an emergency care centre.
Article

What the latest data tells us about public satisfaction with the NHS

The latest on public satisfaction with the NHS, the context and stats from the weekly winter SitRep.

31 March 2022
A healthcare worker wearing PPE, adjusting their mask and visor.
Article

What the latest data tells us about COVID-19 and the NHS

The latest data shows COVID-19 hospital admissions, bed occupancy and staff absence continuing to rise.

24 March 2022
A hospital building
Article

What the latest data tells us about long waiters for elective care

The latest data on long waiters, how it compares to previous years, and how the challenges can be combatted.

17 March 2022
A row of ambulances outside a hospital.
Article

What the latest data tell us about ambulance handover delays

The latest data on handover delays, how it compares to previous years, and how the challenge can be combatted.

24 February 2022
A doctor and a nurse check a board.
Article

What the latest data tells us about bed occupancy

The latest data on how bed occupancy compares to previous years, and the impact on frontline services.

17 February 2022
A male patient sitting up in a hospital bed.
Article

What the latest data tells us about delayed discharges

The latest data on why discharges are proving such a problem, and the impact on services.

10 February 2022

Rising to the challenge

Two women having a conversation.
Case Study

Patient-initiated follow up in Leicester, Nottinghamshire, Norfolk and Norwich

Three trusts have substantially reduced unnecessary outpatients appointments, overdue referrals and waiting lists through patient-initiated follow up.

10 November 2023
Case Study

Turning Point: Crisis Support and Recovery Lounge

How drop-in support services in Manchester are filling a gap in mental health provision, reducing A&E attendance and complementing the wider system.

26 October 2023
Milton Keynes cataract surgery
Case Study

Treating more cataract patients and reducing waiting times

Treating more low-complexity cataract patients to reduce the backlog at Milton Keynes University Hospital NHS Foundation Trust.

7 September 2023
Guy's and St Thomas' urology improvement insight
Case Study

Reducing the elective backlog

The urology team at Guy’s and St Thomas’ NHS Trust reduced the backlog of patients waiting for a prostate procedure.

20 July 2023
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Related content

Matthew Taylor headshot
Confed Viewpoint blogs

Ministers need a long-term plan for the NHS, not a quick fix

While government support is welcome, it often comes too late. To avoid crisis, it has to step up ahead of crunch times.

16 January 2023
A carer supporting a patient with their arms locked together.
Briefing

Discharge funding to address unprecedented NHS pressures

Ahead of an anticipated statement in the House of Commons from the Secretary of State for Health and Social Care, we briefed MPs on NHS leaders views.

9 January 2023
The main entrance to an emergency department.
Report

Re-envisioning urgent and emergency care

Five measures that could reimagine urgent and emergency care, manage demand and improve patient care, experience and outcomes

1 December 2022
Suzanne Mason headshot
Audio

Corridor medicine could help with ambulance handover delays

Professor Suzanne Mason on corridor care, demand management, patient handovers and an urgent and emergency care system on the brink.

23 November 2022
Layla McCay
NHS Voices blogs

What the NHS needs from the winter plan

There are things that can and should be done right now to make sure we protect patients and staff as much as possible ahead of winter.

12 August 2022
A carer supporting a patient with their arms locked together.
Report

System on a cliff edge: addressing challenges in social care capacity

Government urged to take action on the social care workforce crisis or risk putting the care and safety of patients in the NHS in jeopardy.

28 July 2022
Graphic of abstract shapes with the title Integration and Innovation in Action
Report

Integration and innovation in action: community capacity

Exploring how local integration is driving efforts to improve outcomes for patients and local communities.

11 January 2022
Staff in PPE.jpg
Report

Under pressure

How the government and national bodies can ease pressures on the frontline this winter.

11 November 2021
A hospital corridor.
Briefing

A system approach to the demand crunch

Exploring the practical measures that need to be put in place to enable the NHS to respond to rapidly rising demand.

18 August 2021