Live in Care

Excess winter deaths’ stir fears over NHS ability to cope

The capacity of the National Health Service to cope with a difficult winter has been called into question by figures that reveal last year saw the highest number of “excess winter deaths” since the start of the millennium. Almost 44,000 people are estimated to have died in 2014-15, with 27 per cent more people dying in the winter months compared with the non-winter months, the Office for National Statistics said. This is the highest number since 1999/2000, when the state of the NHS prompted Tony Blair, then prime minister, to promise to raise health spending to the European average.

Claudia Wells, head of mortality statistics at the ONS, said that, while the cold temperature had been a factor, “most of last winter was warmer than average”.

She said a big cause of the rise in deaths had been the flu virus, “with estimates showing that the flu vaccine was not as effective this winter compared to previous years”.

The next few months are promising to be testing ones for the health service, as the activity of the El Niño weather phenomenon points to the coldest winter for several years. NHS insiders say it is entering winter with waiting targets further adrift than ever before in departments such as accident and emergency.

The political sensitivities surrounding the state of the NHS were underlined on Tuesday, when George Osborne chose to announce the settlement for the NHS in advance of Wednesday’s wider announcement of departmental spending allocations. He promised an “unprecedented” funding boost, which included an extra £3.8bn in 2016-17.

The ONS said the majority of deaths had occurred among people aged 75 and over. There were an estimated 36,300 excess winter deaths in this age group in 2014/15, compared with 7,700 in people aged under 75. More women than men died in 2014-15, a pattern seen in previous years. Excess winter deaths among men increased from 7,210 to 18,400, and female deaths from 10,250 to 25,500 between 2013/14 and 2014/15. Respiratory diseases were the underlying cause of death in more than a third of all excess winter deaths last year. A geographical spread saw excess mortality at its highest in the south-west in 2014/15 and joint lowest in Yorkshire and the Humber, and Wales.

Last year’s rise comes against a backdrop of significant decreases since the 1950s. Excess winter mortality — the difference between the average number of deaths over the winter and the rest of the year — has fallen significantly during the past six decades. The ONS said this reflected improvements in healthcare, home insulation and the introduction of the flu vaccination programme. However, after a drop in 2013/14, deaths had increased “substantially” in 2014/15.

Janet Morrison, chief executive of Independent Age, a charity for older people, said that last year the flu vaccine had been effective in only a third of cases. However, even discounting the impact of the flu, the figures were still far higher than in previous years, she said. “Councils, the government and energy companies need to help with things like insulating homes and assistance with energy bills for vulnerable customers,” Ms Morrison added.

Heidi Alexander, shadow health secretary, said the “appalling” figures were “a national scandal”. She added: “The sad truth is that government cuts to social care have left too many older people without the vital help they need to stay healthy and independent in their own home. “With the NHS facing its most difficult winter in a generation, ministers need to get their heads out of the sand and ensure older people are properly supported over the coming months.”

Financial Times – Wednesday 25th November 2015

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