How we are managing winter pressures
Each of our hospitals continues to be incredibly busy during this winter period yet they are also helping each other out in unprecedented ways.
Barely a day passes without a site registering the highest levels of operational alert because of demand in the emergency department (ED) and pressure on beds.
Fortunately, unlike other parts of the country, ‘flu levels in London remain relatively low, though our hospitals report that levels of sickness among patients are high.
As departments make huge efforts to weather the winter, teams are working across sites to exploit the benefits of being part of a group.
For example, The Royal London was almost overwhelmed with stroke patients in the first week of the New Year, with 17 cases in the emergency department and a potential three-day wait for admission to a bed.
To avert a crisis, managers diverted new patients to the National Hospital for Neurology and Neurosurgery at Queen Square, took some of the existing ones to the stroke ward at Newham, and brought in community stroke teams from Tower Hamlets and Waltham Forest to help out.
St Bartholomew’s hospital, with no emergency department, reduced planned activity so it had space for inter-hospital transfers that relieved pressure elsewhere.
It also brought cardiology patients in a day before their planned procedure so other sites could use the beds. This happened almost every day in the first week of 2025 – four from Whipps Cross, four from The Royal London, and one from Newham.
Later a leak at Whipps Cross put three resus cubicles out of action so we diverted ambulances to other hospitals. Across January, more than 270 emergency patients were transferred in this way, representing one in 20 emergency admissions.
Ensuring ambulances go to EDs with available capacity helps maintain access to our services and minimises delays to their crews getting back out on the road.
These cross-site arrangements are facilitated daily by our central Operations Hub, working with the London Ambulance Service, yet wouldn’t work without the active collaboration of hospital colleagues.
For example our clinically-led delivery group, chaired by Dr Malik Ramadan, medical director of The Royal London, is driving pathway improvements in stroke, fractured hips and cardiac care so patients transfer promptly for specialist tests.
Simon Ashton, chief executive of Newham, said: “January and February are the toughest months for hospitals so we’re right in the middle of the peak of the pressure. What we’ve noticed about this winter is that our group of hospitals have worked incredibly well together to manage it.
“When we’ve seen differing levels of pressure, the hospitals have supported each other by taking ambulances, or moving patients. We are now working as a networked group of hospitals, and that has been another step up in our integration.”