Over the winter there was only one story to be written about the NHS - why is not there a winter crisis? The latest report from the winter and emergency services team (WEST) confirms part of the answer - no influenza.

1In fact, the Royal College of General Practitioners' 'spotter' practice survey indicates that GP consultation rates for flu and flu-like symptoms barely scraped into the 'normal seasonal activity' category. Last winter (1999-2000) consultation rates at their peak were three times higher than this winter.

Elderly people were the age group least affected.

With so little illness around anyway, and with over 65 per cent of over-65-year-olds receiving immunisation, this is perhaps not surprising.

Together with increased numbers of beds, better planning of activity and the clear message from the centre that any local problems must be dealt with swiftly, the NHS had a quiet winter for news stories.

Statistics produced by WEST from local situation reports indicate some of the reasons for this journalistic silence. Long trolley waits, for example - those greater than 12 hours - fell by 70 per cent, from over 4,100 to 1,250. And waits in excess of 24 hours fell from 132 to just two. Cancelled elective operations also fell slightly - by around 5 per cent over the whole winter period (but, for half the time, the number cancelled was higher this year compared to last).

Stories of patients being shunted around from hospital to hospital were also few and far between: there were 25 per cent fewer transfers for non-medical reasons of patients in intensive care. All this could suggest activity in general also declined, but WEST reports activity up across the board. For example, from the beginning of November 2000 to the end of February this year, the number of ambulance/999 calls totalled over 1. 43 million - an average of around 13,000 a day across England. Overall, this was 11 per cent higher than last winter. Calls to NHS Direct were also up - by around 60 per cent, and accident and emergency attendances over the winter period were 1 per cent higher. Interestingly, emergency admissions were also higher - up by nearly 5 per cent.

Although the WEST report cites increased resources along with better planning and co-ordination as the main reasons for reductions in delayed admissions, it does not speculate on the possible causes of the increased activity this winter. The fact that more beds were available suggests one reason for increased activity in hospitals - supplier-induced demand.

WEST claims that over the last calendar year, general and acute bed numbers increased by 1,337; intermediate care beds increased by 900 and, by midJanuary this year, there was an increase in critical care beds of around a fifth. Could it be that, with all these extra beds and relatively low levels of flu, admission thresholds were lowered? As they say, more research needed.