1. NHS Winter Pressures 2014/15 Did flu have an impact? Jess Stokes, Public Health Registrar Knowledge and Intelligence Team (East)

2. Impact of cold weather on health 2QOF Public Health Indicators – achievement distributions Circulating Infectious diseases - flu and norovirus Extent of snow and ice - falls and injuries Increased morbidity and mortality - heart attack, stroke, respiratory disease Hypothermia Link to fuel poverty, poor housing and health inequalities

3. Impact on NHS and Social Care A&E waits A&E attendances Emergency admissions Bed occupancy Cancelled operations Delayed discharges GP consultations = Extra pressure on already stretched system 3QOF Public Health Indicators – achievement distributions

4. Winter Pressures Bulletin 4QOF Public Health Indicators – achievement distributions Monthly bulletin summarising data PHE Centre Area Audience – PHE Centre Directors, Healthcare PH Leads, Screening & Imms Teams, DPHs PHE and NHSE data Vast amount of (publically available) data Nov 14 to Feb 15 plus Summary bulletin

5. Difficulties encountered 5QOF Public Health Indicators – achievement distributions Data sharing Pre-election sensitivity period Different time periods/geographies Validity of data – daily sitreps Format of data

6. 6QOF Public Health Indicators – achievement distributions System already under pressure Data sources: Monthly hospital activity data, NHSE A&E waiting times and activity, NHSE

7. 7QOF Public Health Indicators – achievement distributions Bed occupancy Data sources: Bed availability and occupancy data - overnight, NHSE

8. 8QOF Public Health Indicators – achievement distributions Influenza Data source: PHE Eastern Field Epidemiology Unit

9. 9QOF Public Health Indicators – achievement distributions Influenza vaccination rates Target 75% Mismatch between vaccine and circulating strain Flu vaccine remains best way to protect people from getting flu Data source: Seasonal flu vaccination uptake, PHE

10. 10QOF Public Health Indicators – achievement distributions Norovirus and rotavirus Data source: PHE Eastern Field Epidemiology Unit

11. 11QOF Public Health Indicators – achievement distributions A&E waits Data source: A&E waiting times and activity, NHSE

12. 12QOF Public Health Indicators – achievement distributions Operations cancelled Data sources: Cancelled elective operations data, NHSE Critical care capacity and urgent operations cancelled, NHSE

13. 13QOF Public Health Indicators – achievement distributions Delayed transfers of care Data source: Delayed transfers of care, NHSE

14. 14QOF Public Health Indicators – achievement distributions The story of Winter 2014/15 (Anglia and Essex)

15. 15QOF Public Health Indicators – achievement distributions The story of Winter 2014/15 (SMH)

16. 16QOF Public Health Indicators – achievement distributions A&E delays: why did people wait longer last winter? https://www.gov.uk/government/publications/ae-delays-why-did-patients-wait- longer-last-winterhttps://www.gov.uk/government/publications/ae-delays-why-did-patients-wait- longer-last-winter (Monitor)

17. 17QOF Public Health Indicators – achievement distributions Summary Causes of winter pressures complex and multi-factorial Lots of data available – how can it best be used? What will this winter bring?

18. Questions and Discussion Do you routinely analyse data on winter pressures? If yes, what do you provide and to whom? 18QOF Public Health Indicators – achievement distributions