Flu wave hits England’s busiest A&E

At England’s busiest emergency unit, all the beds are full by midday.

As one patient leaves his room at Leicester Royal Infirmary’s acute unit, cleaning staff are waiting outside.

He is barely out of the room before the bed is stripped and bleach is sprayed. The next patient is already waiting to come in.

Over two days the BBC was given access to the hospital to witness first-hand how it is coping with an early surge of winter bug cases.

Flu season has hit a month earlier than normal this year, with experts warning there appears to be a more severe strain of the virus – mutated H3N2 – circulating.

Hospitals around the country, like this one in Leicester, are doing all they can to avoid becoming completely overwhelmed.

But staff at the Royal Infirmary say increasing numbers of people coming to hospital with the flu and other winter bugs – together with existing pressures – are hitting the hospital hard.

They already worry about how they will cope this winter.

When 19-year-old Paige arrives at the hospital by ambulance, she’s put on a trolley while a resus bed is cleared. She’s got the flu but also has type 1 diabetes and has dangerously high sugar levels. She is curled in a ball, pale and shaking.

“There are patients in every cubicle,” Consultant Saad Jawaid says, as Paige is wheeled in. “Another ambulance has just rocked up.”

We watch as he works with colleagues in the resus unit to find desperately needed bed spaces.

“When beds are full we have to move people – sometimes that means those who can sit are moved out of beds and into chairs,” he says.

Paige is given insulin and fluids to try to stabilise her sugar levels. The doctors hope her diabetes will be controlled soon. Getting better from the flu will take longer.

The following day, Paige is in a side room on the acute assessment unit.

“I do struggle a lot in winter,” she says. “I was maybe in here two or three weeks ago. Infections and stuff just seem to hit harder than usual.”

The number of flu patients in hospital has hit a record high in England for this time of year with NHS leaders warning the country is facing an unprecedented flu season.

At its busiest times, the emergency unit here in Leicester saw more than 1,000 patients a day last winter. On one of the days we were here, 932 patients came through the door. That number is expected to rise in the coming weeks.

Attendance levels are already around 8% higher this year than last year. And the unit faces a daily shortage of between 50 to 70 beds.

At the Royal Infirmary around 64 beds are currently taken up by people with respiratory viruses, including flu.

We meet one patient who waited 106 hours for a bed on a ward. Another, Gary, came in with a stomach bug and finally got a bed after 34 hours.

By late afternoon, the children’s waiting area is full. Parents stand rocking crying babies as every seat is taken.

Respiratory cases of flu and bronchiolitis, a condition affecting the lungs of young patients, are rising fast here too.

In just 30 minutes, 30 children arrive at the department.

At five months old this is Oscar’s first winter and his first trip to A&E. His mum brought him in because he was wheezing and struggling to breathe. A few hours after arriving, he is finally seen by a doctor and told he has bronchiolitis.

“These bugs are everywhere at the moment – Oscar’s older brother brought it home from school and now Oscar has it,” says his mum.

Richard Mitchell has been the chief executive of University Hospitals Leicester NHS Trust since 2021 – and has witnessed first-hand how it gets harder to cope with each winter that passes.

“We are already seeing very high levels of flu,” he tells us. He expects numbers to climb into January. “That is one of the many things I am concerned about at the moment.

“At this point I feel we are working at the limits of our ability.”

The hospital has introduced a new system to manage the flow of patients arriving at its emergency department, as pressure grows on front-line services.

Receptionists, nurses, all the way up to consultants, now sit in a bank of desks at the entrance, assessing patients as they arrive.

This speeds up triage, moving people away from the front door and ensuring those in greatest need receive urgent care.

Staff say the range of cases has become increasingly polarised. Some of the most seriously ill patients are being driven in by relatives because of long waits for ambulances.

At the other end of the scale, people turn up with minor complaints after struggling to secure GP appointments. “Last week someone came in with a coldsore,” one nurse tells us.

Experienced staff can redirect those who do not need urgent care, helping them to book GP appointments or pointing them towards pharmacies and other services. Now one in 10 patients are sent away, although staff admit it can lead to frustration.

Security has been tightened following one violent incident, with glass screens installed and 24‑hour guards now in place.

Leicester Royal Infirmary has introduced new measures each year to boost capacity and manage rising demand. Winter pressures continue to grow, while the quieter summer months have become a thing of the past.

To reduce ambulance queues, prefabricated structures were converted into a permanent unit with 14 beds – all are full during the BBC’s visit. Without them that would have been 14 ambulances queueing for hours to unload their patients.

Unlike many hospitals, Leicester’s emergency unit is not totally overwhelmed by elderly patients. Frail patients are streamed directly to specialist areas, including a frailty unit, or supported in the community to avoid long hospital stays.

Preston Lodge, a former care home bought by the trust, now provides 25 beds, with 14 more opening on December 15. Patients who no longer need acute care – but still require rehabilitation or support – are moved there while awaiting care packages.

“We aim to get people better ready for going home and hopefully keep them stronger and more independent so they aren’t back in hospital so frequently over the winter,” says head of nursing, Emma Roberts.

Looking ahead, Mr Mitchell expects waits and delays to only get worse for patients in the coming weeks.

For the first week in January – traditionally the busiest each year – the hospital plans to free up more emergency beds, but that means delaying other operations and procedures.

He says: “We will not be able to provide timely care to every patient this winter but we will continue to do our utmost to ensure that patients are treated with dignity and respect to ensure they receive safe care and we will do everything possible to manage those waiting times.”

Hospital leaders here are trying to take proactive steps – rather than simply reacting to each crisis. But staff and patients alike warn that hospitals across the country are caught in the middle of a system, many believe, is close to breaking point.

In a statement, the Department of Health and Social Care said it was “under no illusions this is going to be a tough winter for our NHS”.

A spokesman said: “Flu cases are rising, so it is vital that patients can get protected. Almost 17 million vaccines have been delivered this autumn – 350,000 more compared to this time last year.

“There is no national shortage of the flu vaccine and we would urge everyone eligible to get their vaccination to protect themselves and their loved ones.”

Get our flagship newsletter with all the headlines you need to start the day. Sign up here.