Winter Pressures? When Did They Ever Go Away?

By Tara Marshall, Founder and CEO, These Hands Academy Ltd

Every year, as the nights draw in and temperatures fall, we hear the same familiar phrase: winter pressures are coming. But I have to ask, when did they last go away? We have patients receiving care in hospital corridors, emergency departments struggling with overcrowding, ambulances queuing outside hospitals and waiting lists stretching into the millions. And yet, every autumn, we begin another conversation about preparing for winter, as though this is a temporary challenge rather than a year-round reality. Perhaps it is time to change the conversation.

The latest NHS data tells a compelling story. In September 2026, England recorded 2.44 million A&E attendances, the busiest September on record, while average adult acute hospital bed occupancy reached 94.9%. Meanwhile, the elective waiting list stood at approximately 7.4 million patient pathways in August 2026 (NHS England, 2026a). These are not figures from the depths of winter. NHS England also recorded its busiest summer ever, with more than 7.2 million A&E attendances between June and August 2026 (NHS England, 2026b). The Health Services Safety Investigations Body has identified evidence that patient-flow pressures are now constant, rather than simply seasonal (HSSIB, 2026). Winter adds pressure, but it is no longer the only reason our hospitals are overcrowded.

Behind every statistic is a person. Someone waiting for a bed, someone frightened or confused, someone whose deterioration may be difficult to recognise in an overcrowded environment. Corridor care is not simply an operational inconvenience; it raises fundamental questions about patient safety, infection prevention, privacy, dignity and the ability of staff to deliver compassionate care. HSSIB's investigation into temporary care environments highlighted the risks associated with providing care in spaces never designed, staffed or equipped for that purpose (HSSIB, 2026). For older people, particularly those living with frailty, dementia or multiple long-term conditions, an avoidable hospital admission can bring further complications, including deconditioning, loss of independence and prolonged

recovery. We should never allow the exceptional to become the everyday.

Having spent much of my nursing career caring for critically ill patients, I understand how vital our hospitals are when people genuinely need them. But what if we started the conversation somewhere different? Rather than continually asking how we accommodate more people within overcrowded hospitals, perhaps we should ask how we can help more people remain well, safe and supported in the place they call home. This is not about preventing necessary admissions or replacing clinical expertise with technology. It is about recognising deterioration earlier, strengthening community responses and intervening before a manageable concern becomes a crisis. It is also about giving people greater choice over where and how they receive care.

Through These Hands Academy's Connected Care Programme across Leicester, Leicestershire and Rutland, we have seen what becomes possible when care staff are equipped with the confidence, knowledge and tools to identify deterioration earlier. Combining telehealth observations, NEWS2, recognition of soft signs and clear escalation pathways helps connect care homes with primary care and community services. Our programme evaluations have identified reductions in hospital admissions, improvements in workforce confidence and greater use of timely, in-hours clinical support (These Hands Academy, 2026). But the greatest learning has never been simply about the technology. Technology does not deliver integrated care. People do. Digital devices enable the connection, training builds confidence, and strong relationships ensure that when someone raises a concern, somebody responds.

This matters because care homes, supported living services and neighbourhood teams are not peripheral to our healthcare system. They are fundamental to its future. The government's 10 Year Health Plan identifies three important shifts: hospital to community, sickness to prevention, and analogue to digital (Department of Health and Social Care, 2025). Yet these ambitions will remain aspirations unless we invest in implementation, workforce development, shared information, clinical governance and meaningful partnerships across organisational boundaries. Telehealth offers a valuable opportunity, but purchasing devices alone will not change outcomes. The real transformation happens when technology is embedded into everyday practice and the people delivering care are supported to use it safely and confidently.

Winter will always bring additional challenges. Respiratory infections, influenza and seasonal illness will continue to place demands on health and care services. But perhaps we need to stop measuring success solely by how many patients our hospitals manage to accommodate and start looking more closely at how effectively we support people before they reach crisis point. How many episodes of deterioration were recognised early? How many potentially avoidable admissions were prevented? And how many people were supported to remain independent and well in their own communities? These are the questions that should shape our approach to year-round prevention.

At These Hands Academy, we believe that genuinely integrated, neighbourhood-based care offers an opportunity to shift the focus from managing pressure to preventing avoidable harm. Our work brings together frontline experience, independent evaluation, workforce development and practical implementation to turn ambition into everyday practice.

As another winter approaches, perhaps the question should no longer be simply how we prepare our hospitals for the pressure, but what we can do differently, together, to prevent some of that pressure reaching their doors in the first place.

Because whatever the season, our ambition should remain the same:

Ensuring nobody deteriorates unnoticed. Find out more: hello@thesehandsacademy.co.uk

References

Department of Health and Social Care (2025) Fit for the future: 10 Year Health Plan for England. London: Department of Health and Social Care. Available at: https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future (Accessed: 3 November 2026).

Health Services Safety Investigations Body (HSSIB) (2026) Patient care in temporary care environments. 8 January. Available at: https://www.hssib.org.uk/patient-safety-investigations/patient-care-in-temporary-care-environments/investigation-report/ (Accessed: 3 November 2026).

NHS England (2026a) Ominous signs of winter pressure growing as A&Es and ambulances see record September. 8 October. Available at: https://www.england.nhs.uk/2026/10/ominous-signs-of-winter-pressure-growing-as-aes-and-ambulances-see-record-september/ (Accessed: 3 November 2026).

NHS England (2026b) Busiest summer ever for NHS but A&Es see record numbers within four hours. 10 September. Available at: https://www.england.nhs.uk/2026/09/busiest-summer-ever-for-nhs-but-aes-see-record-numbers-within-four-hours/ (Accessed: 3 November 2026).

These Hands Academy (2026) Connected Care Programme: implementation and evaluation findings, Leicester, Leicestershire and Rutland. Internal programme evaluation.