• Performance on core metrics, including occupancy, largely better than last December
  • NHS England praises “hard work and preparation of NHS staff”
  • But mild weather a major factor, with providers braced for major demand spikes

Ambulance handover delays were down by nearly 30 per cent in December, data from acute providers published today suggested.

Mild weather likely helped local systems maintain better performance against several key winter metrics, including bed occupancy and patient length of stay, compared to the same month last winter, experts said.

NHS England praised “the hard work and preparation of NHS staff” following the encouraging holiday period data, issued today as part of the winter daily SitRep data release, published every Thursday over winter. 

It is, however, too early to make a full assessment of the role NHS winter planning contributed. Providers said they were bracing themselves for cold snaps and demand spikes in the coming weeks and stressed the worst of winter pressures are most likely still to come.

NHS acute providers reported 39,426 ambulance handover delays of over 30 minutes in the four full weeks in December – 15,494 less than the 54,920 recorded in a comparable period last winter, the Nuffield Trust’s analysis of the SitRep data showed (See box below, top table).

The data likely made for welcome reading for system leaders, who made cutting handover delays a major target for this winter, after long delays last winter were branded “unacceptable” by then health secretary Jeremy Hunt.

Caution is also advised when interpreting the ambulance handover data. It was revealed last winter there were significant discrepancies between the data acute trusts reported and the ambulance trusts’ independent data, which is not made public, but used for operational purposes.

The Nuffield Trust analysis also showed bed occupancy was at 89.3 per cent for the last two weeks of December, its lowest for six winters against the comparable period. But analysts stressed caution over the figure as the festive period can prove an anomaly, as hospitals bid to get patients home for Christmas.

The number of beds occupied by patients who have been in hospital 21 days or more was also lower in December than the comparable period last winter. Cutting so called super stranded patients is also a core goal for system leaders (See box below, bottom table).

Nuffield Trust research analyst Jessica Morris said: “The average temperature was 6.9 degrees in December, the second warmest in the last five years, and up from the 4.8 degrees reported last year. This milder weather will probably have been a contributing factor to the performance compared to last winter.

“Lower bed occupancy will have improved flow and help ease problems with handover delays.

“We will have to wait and see how performance fares when the temperature drops but the figures are somewhat encouraging, albeit in the context that the coming months will likely be far more challenging.”

Ambulance handover delays over 30 mins December 2018 v December 2017

The four weeks in December2017-182018-19
Week 49 (first full week of December) 11,852 10,675
Week 50 14,323 9,357
Week 51 11,852 9,677
Week 52 16,893 9,717
Total 54,920 39,426
 Super stranded patients December 2018 v December 2017

The four weeks in December> 21 days December 2018> 21 days December 2017

Week 49 (first full week of December)



Week 50



Week 51



Week 52



Analysis by the Nuffield Trust
Note: Week 49 of 2018 commenced Monday 3 December, and Week 49 of 2017 commenced Monday 4 December

NHS Providers praised staff and managers for their efforts over December but warned the system was vulnerable to any demand spikes because it was consistently running on high capacity.

Director of policy and strategy at NHS Providers, Miriam Deakin, said: “Demand for ambulance services continues to grow with more patients arriving at emergency departments last week than at any time last winter.

“The next couple of weeks will be important to get a real sense of how well the service copes with any further spikes in demand. A surge of cold weather or flu now could still have a real impact on a health and care system that is running consistently at high capacity.”

The Society for Acute Medicine, however, warned it was “anticipating mayhem” this weekend as the cold snap sets in and adds further stress to stretched NHS services.

SAM president Nick Scriven said hospitals saw “fits and spells of manic activity” last week. He added: “Influenza is here and is already impacting the NHS and, with colder weather starting to set in, this will further stress already stretched services.

“I and many colleagues across the country are anticipating mayhem this weekend as temperatures drop – but it will come as no surprise to us.”

A statement issued by NHS England said: “Thanks to the hard work and preparation of NHS staff, the health service is performing better this winter than last, with people being seen more quickly in emergency departments, fewer ambulance delays, evening and weekend GP appointments across the country and more people able to leave hospital and get home sooner, all of which is good for patients and makes best use of NHS resources.”