Prof. Christina Pagel Profile picture
Aug 14 7 tweets 4 min read Twitter logo Read on Twitter
SHORT THREAD on current state of the NHS in England:

TLDR: Ambulance response times improving, A&E improving but still bad, diagnosis and treatment waits are not good.

First - ambulance response times higher than pre-pandemic but way down on their peak - thankfully! 1/5 Image
% of people waiting >4 hours from arrival in A&E to either admission *or* discharge is falling but higher than pre-2020.

A *bit* better than 2022.

% waiting >12 hrs *after admit decision* falling.

BUT % who need admission waiting more than 12 hrs from *arrival* is v high 2/5


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However, record number of people waiting for treatment in England, >7.5 million!! One in eight of population!

We are making progress in reducing number waiting more than 18 months at least and increase activity, but waits for ops after cancellation are higher than pre-2020. 3/5


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Relevant to decision to cancel some cancer time to diagnosis targets are our poor performance in both seeing people for an urgent cancer diagnosis within 2 weeks and in starting treatment within 2 months. 4/5


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More generally, number of people waiting for diagnostic tests more than 6 weeks, or worse, 13 weeks, remains much higher than pre 2020.

So in total, imrpovements in the emergency areas (which you'd hope for summer!) but NHS remains very very stretched. 5/5 Image
PS Thank you, as ever, to Bob Hawkins for pulling out the data & doing the charts!
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More from @chrischirp

Aug 3
Covid update: bigger jump in England hospital admissions with Covid this week (40%⬆️). Also now seeing increase (28%⬆️) in number of patients in hospital primarily because of Covid.

Definitely in a wave but starting from much lower base than previous ones 1/6 Image
Not sure how much it will take it off in Aug with holiday season (and biggest increases are in England holiday areas like the South West). There is a new Omicron variant around called EG.5.1 alongside XBB.1.16, and UKHSA estimate it's got about a 20% weekly growth advantage. 2/6 Image
But, as @kallmemeg pointed out, we've not seen big waves in variants with growth advantage of around 20% - previously needed 50% growth advantage+ to get big wave...
3/6
Read 9 tweets
Jul 15
THREAD: what I think is happening with Covid in England right now.

TLDR: while data is sparse & comes with lots caveats, it's all pointing to pretty low Covid prevalence right now. 1/13
Firstly let's look at hospital data. Recorded Covid admissions are lower than they've been in a LONG time.

People often doubt this data because testing has changed (there is less testing in hospitals now). And that's true - but we can dig further into the data too. 2/13 Image
The main testing that's stopped is testing of people with no symtpoms. But if you are in hosp cos of respiratory symptoms, you do get tested! You also get tested if Covid might affect your treatment - this is likely to be true of people in ICU.

So what does the data say? 3/13 Image
Read 15 tweets
Jul 14
THREAD: update on how the NHS is doing across ambulances, A&E, diagnostics & treatments.

TLDR: better than last winter (worst ever) but still much worse than pre pandemic. 1/10
Ambulance response times are much faster than they were this winter which is good, but still significantly slower than there were before "freedom" day in July 2021. 2/10 Image
A&E also better than Dec 2022 but still far higher than pre pandemic & pre summer 2021. A quarter of people still waiting longer than 4 hours.

We are currently (red line) tracking last year (orange line) - which is not a good thing! 3/10 Image
Read 11 tweets
Jul 5
🧵our new definitive @bmj_latest peer-reviewed paper on kids hospitalisations in England!


More accessible & shorter version in this @ConversationUK article from me & @katebrown220
https://t.co/nNQnxiFhrR

read on for the highlights! 1/15bmj.com/content/382/bm…
theconversation.com/covid-in-kids-…
The paper was led by @katebrown220 & specialist docs, with number crunching by @HarrisonDWilde using @BHFDataScience data on all admissions, tests etc.

We looked at all recorded first infections in kids 0-17 rys & any associated hospitalisations from Jul 2020 - March 2022. 2/15
Overall we found almost 30,000 hospital admissions, with peaks coinciding with prevalence peaks as measured by ONS infection survey.

Admissions higher since 'freedom day' & Delta and highest since Omicron. 3/15
Read 16 tweets
Jun 29
THREAD: why the NHS is not the key to saving the NHS

Health care to each according to their need and free for all is the NHS.

To protect that, the absolute number one thing we have to do is reduce need for health care.

My new article for @WiredUK
1/10wired.co.uk/article/christ…
E.g. take diabetes - a 2018 govt report listed as one of biggest issues for NHS accounting for 9% of NHS spend. 1 in 6 people in hosp were diabetic.

2/3 UK adults are overweight - a key risk factor. We now have record number of diabetics.

globally accelerating crisis 2/10

Note that the one of the key enablers of diabetes are widening health inequalities.

Inequality also means that the impacts of having diabetes is felt most among the most disadvantaged. 3/10
Read 14 tweets
May 26
THREAD: latest numbers on Covid in England.

TLDR: Disappointing uptake of Spring Booster but good news is that hospitalisations and deaths are going down and are at lowest we've seen in a while... 1/8
almost 60% of over 75s have had the Spring booster but only about a quarter of immuno-compromised. This is disappointing uptake - at equivalent time last autumn, about 80% of 75+ had been booster. 2/8 Image
sadly disparities by ethnic minority persist, with much lower take up among minority communities.

Additionally too many people - of any age - remain unvaccinated AND primary vaccination will be withdrawn from July! So GET JABBED & GET PROTECTED! 3/8 Image
Read 8 tweets

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