A continuum of perfect storms: the winter forecast for urgent care in the NHS remains bleak

The NHS remains under immense pressure.1 Each part of the system is experiencing demand beyond its capacity, which is continually increasing the problem. This is most vividly illustrated in urgent and emergency care settings. Media images in the next few weeks will portray long queues of ambulances outside emergency departments and patients experiencing prolonged periods of degrading corridor care. Publications will feature stories of patients who have experienced significant harm and trauma due to delayed ambulance responses.Each winter in the past decade has become slightly worse,2 and that trend, which has not been reversed, has resulted in a dire situation that may not yet have reached its nadir. A continuum of often predictable perfect storms has caused a struggling system to reach collapse. Last winter this was exacerbated by a further wave of covid-19, high levels of influenza, and an outbreak of group A streptococcus infection with challenging cold weather….
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