By Multimedia Producer Lottie Kilraine
Health workers are anticipating a busy weekend ahead of the New Year's Eve celebrations, with many trusts struggling to cope.
There are warnings in place that some patients may have to wait longer for an ambulance as services are being stretched to meet demand.
This comes as people are being advised to use GPs, 111 and pharmacies instead.
What is a critical incident?
Trusts have cited record numbers of people attending A&E, calling NHS 111, accessing GP services and calling 999 as reasons why they have moved to a critical incident.
When a critical incident is declared it allows a trust to put in place extra measures to safeguard the health and safety of patients.
Among these provisions is the option to seek mutual aid, cancel all training to allow for the redeployment of all clinical staff, no longer take bookings for urgent non-emergency transportation and increase third-party provider provision.
Which trusts have declared incidents?
Trusts and ambulance services across England are struggling with a surge of demand.
NHS England reported that last week there were an average of 3,746 people a day in hospital with flu, compared with 2,088 the week before - up almost 80% in seven days.
Dorset County, Portsmouth and Nottingham University Hospitals are the latest to make declarations on Thursday after warning they are being overwhelmed with patients while suffering staff shortages.
The Royal Cornwall Hospitals NHS Trust has urged people heading to the county to celebrate New Year to bring their own medications including pain relief and rehydration powders.
The trust, that has urged people to only call 999 or use the emergency department for life-threatening illnesses and injuries, tweeted the advice ahead of the upcoming celebrations.
It said: “Heading to #Cornwall this #NewYear? Just in case, be wise and bring these three self-care kings! Pain relief, flu and cold remedy and rehydration powders. And don’t forget to pack any prescription medicines, too. #HelpUsHelpYou”.
Medway Foundation NHS Trust in Kent and Wrightington, Wigan and Leigh NHS Foundation Trust in Lancashire had previously declared critical incidents last week.
The NHS in Leeds said “some planned surgery will be cancelled” in order to prioritise urgent and emergency care, though it has not declared a critical incident.
Meanwhile in Wales, Swansea Bay University Health Board’s Executive Medical Director Dr Richard Evans urged the public to only attend A&E for life-threatening illnesses and serious injuries.
He said: "Winter is always an extremely busy time for the health service, but in common with other health boards in Wales we are seeing even more acutely unwell patients than we normally would."
A similar plea has also been made by Betsi Cadwaladr University Health Board, where red ambulance calls and flu transmission is up "hugely" on last year.
Angela Woods, Executive Director of nursing at Betsi Cadwaladr, has made a direct plea to the public to help keep the region’s acute hospitals safe from unnecessary infections.
She said: "We recently increased the times visitors can attend to see loved ones but with this comes with some civic responsibility.
"Firstly, no one should even consider entering a hospital if they have any symptoms of a cold or flu, or know they are unwell.
“If you do, you put the wellbeing of your loved one at risk and it also threatens the health of our staff, who will not be able to care for the population if they contract flu, Covid or RSV."
Six ambulance services have also declared critical incidents since December 19, with North East Ambulance Service and East of England Ambulance Service declaring twice.
South East Coast Ambulance Service (SECAmb), which declared a critical incident on December 19 following high demand, is urging the public not to drink alcohol to excess this New Year's Eve to ease pressure on the service.
The service which covers, Brighton & Hove, East Sussex, West Sussex, Kent, Surrey, and North East Hampshire, is anticipating a busy weekend as demand remains high following the long Christmas bank holiday weekend.
South Western Ambulance Service is also advising the public to “think carefully” before dialling 999 as by 11.30am on Wednesday, there were 482 patients waiting for ambulances across the south west with 106 waiting outside hospitals.
A spokesperson from Yorkshire Ambulance Service said it was receiving an “extremely high volume of calls” and said anyone with less serious illnesses or injuries should consider “self-care, their local pharmacy, GP surgery or urgent care centre”.
The North East Ambulance Service has also asked the public to use emergency services wisely over the New Year weekend.
People have been urged not to call 999 or attend A&E in Greater Manchester unless it is a life-threatening emergency as demand rises 'beyond anything experienced before'.
"Unprecedented levels" of people attending A&E coupled with staff sickness and an "increased prevalence of flu and Covid" has led to long delays in hospital and for ambulances, the trust said.
There have not been any critical incidents declared in Scotland.
However, the chairman of the British Medical Association in Scotland has said the NHS is "broken" and cannot survive in its current state.
Dr Iain Kennedy said Scotland faces "crises across workload, workforce, working conditions, pay and pensions".
In his view there needs to be a national discussion about the future of the health service, adding that the Scottish government must address shortfalls in the number of doctors and GPs.
He said: "All the statistics tell us that it’s a desperate state of affairs. Things are as bad, or worse, than they have ever been. Winter is a meaningless term now - this entire year has been winter.
"But looking beyond the statistics, looking at the people behind the statistics, the picture being painted is even more grim and concerning."
What are patients being advised to do?
In general the advice from the NHS over the festive and New Year period has been:
Call the pharmacy for medication advice
Call your GP for health advice
Only call 999 in a life-threatening emergency
If you are unsure, use NHS 111 Online to get assessed and directed to the right place for help
Remember to order and collect any medication prescriptions before the weekend
The public is being asked to help manage the additional pressure on health services by reserving 999 for genuine emergencies and by making use of alternatives when it’s not serious.
Anyone heading out to celebrate on New Year's eve has been urged to not to drink alcohol to excess.
Revelers are also being urged to plan how they are getting home and are being asked to look out for others.
SECAmb Executive Director or Operations, Emma Williams, said: "We have faced significant pressure on our services for many weeks but we know that New Year’s Eve can bring additional challenges.
"Of course, we know that many people will want to celebrate the new year but we ask that they do this sensibly, understanding the impact their decisions can have on an already stretched ambulance service.
"I would like to thank all our staff and volunteers for their hard work and professionalism at this busy time and urge the public to show their support by using NHS services wisely."
When to call 999:
If you think a patient is suffering from one of the following you must dial 999 for an ambulance:
Heart attack (e.g. chest pain for more than 15 minutes)
Sudden unexplained shortness of breath
Unconsciousness (even if the patient has regained consciousness)
Traumatic back/spinal/neck pain
You should also call an ambulance if:
You think the patient’s illness or injury is life-threatening
You think the illness or injury may become worse, or even life-threatening on the way to the hospital
The patient needs the skills or equipment of the ambulance service and its personnel
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