England flu hospital cases hit record: when to use A&E

If you’re feeling rough this week, you’re not alone. England has just logged a record number of people in hospital with flu for this point in winter: an average of 1,717 patients each day last week, including 69 in critical care. NHS leaders say the season has started earlier than usual and there’s no clear peak yet. That combination is already straining services.

So let’s keep this simple. A&E and 999 are for life‑threatening emergencies. That means symptoms such as severe chest pain, signs of stroke (face drooping, arm weakness, speech trouble), serious breathing difficulties, heavy bleeding, or a serious injury. If you’re unsure whether it’s an emergency, you can still call 999 and be guided-call handlers are trained to triage.

If it’s urgent but not life‑threatening-or you’re not sure where to go-use NHS 111 first. You can check symptoms online, in the NHS App, or by phone. 111 can book an out‑of‑hours GP, direct you to an urgent treatment centre, fast‑track you to A&E when needed, or advise safe self‑care at home. It’s designed to save you time and get you to the right place, first time.

Pharmacies can now treat more than you might think. Through Pharmacy First, trained pharmacists can assess and supply treatment (including some prescription‑only medicines under NHS protocols) for seven common conditions such as sore throat, earache, sinusitis, shingles, infected insect bites, impetigo and uncomplicated UTIs in women. Many are open late, and this winter the NHS says pharmacies can also provide emergency contraception and support people newly starting antidepressants.

Why are hospitals asking you to choose carefully? Because thousands of winter A&E visits are for things that can be sorted elsewhere. Last winter (1 November 2024 to 28 February 2025) there were 200,028 attendances in England for minor problems including 96,998 sore throats, 83,705 earaches, 6,382 blocked noses, 8,669 itchy skin, 3,890 ingrowing nails and 384 hiccups-more than 2% of all attendances. Those cases tie up stretched teams when ambulances and resuscitation bays are needed for emergencies.

We also need to be honest about pressure in the system. Ambulance handovers remain slow in places-30% of arrivals last week waited at least 30 minutes, with about 10% delayed over an hour. That knock‑on means longer waits inside A&E too. None of this is your fault as a patient; it’s context to help you pick the best door first.

Access to GPs has improved this year, but it’s still uneven. The Care Quality Commission says only around half of people find it easy to get through by phone, and access is tougher in some deprived areas. That’s one reason people seek same‑day help in A&E. Using 111 and pharmacy routes can often get you timely care while keeping emergency bays free.

Frontline clinicians are clear that long A&E delays stem from capacity, flow and staffing. The Society for Acute Medicine reports nearly half a million 12‑hour waits across ten months this year, warning that corridor care harms patients and staff. The headline is simple: choose the right service when you can, and push nationally for fixes on beds, workforce and social care.

Older people need extra protection this winter. England’s Chief Medical Officer, Professor Chris Whitty, says infections like flu and pneumonia in older adults are too often under‑recognised, and they can raise the risk of complications such as stroke or heart problems. If you’re supporting an older relative, act early: check vaccines, spot red‑flag symptoms, and use 111 or your pharmacist for prompt advice.

Industrial action is in the mix too. Resident doctors (formerly junior doctors) plan to strike from 7am on 17 December to 7am on 22 December. At a board meeting, NHS England chief executive Sir Jim Mackey said the timing “feels cruel” and “calculated to cause mayhem”, reflecting leaders’ fear of extra disruption during a flu surge. Whatever your view on the dispute, it’s worth planning repeat prescriptions and knowing your first port of call for non‑emergencies.

How to care for flu at home if you’re otherwise well: rest, keep warm, drink fluids, and use paracetamol or ibuprofen for fever and aches. Ask for an urgent GP appointment or use 111 if you’re 65+, pregnant, have a long‑term condition, have a weakened immune system, or your symptoms aren’t improving after a week. Call 999 or go to A&E if you develop sudden chest pain, struggle to breathe, or cough up lots of blood.

One last thing we can all do: get protected. The NHS has delivered over 16 million flu jabs so far this autumn in England, and pharmacists are seeing millions of people for quick consultations without a GP appointment. If you’re eligible for a free vaccine-or you care for someone who is-book it. It’s a small action that helps you, and it helps the service hold the line for emergencies.