NHS Winter Pressure: Strikes, Flu—and What Works

451,275 flu vaccines were delivered in the first week of December 2025 in England—about 28,000 more than the same week last year. That’s the good news. The harder news is happening at the same time: a five‑day resident doctors’ strike (17–22 December) alongside an unusually early and heavy flu season, with record numbers of patients in hospital with flu for this time of year.

If you’re trying to get care, manage a long-term condition, or simply avoid spending Christmas or New Year in A&E, this isn’t background noise. It’s a stress test of the NHS—one that exposes the same structural problems we keep seeing in the Healthcare & NHS Reform conversation: fragile winter capacity, uneven access routes, and a workforce plan that doesn’t properly absorb shocks.

Here’s what to do right now as a patient (or carer), what the NHS is already doing, and what needs to change if we want winters to stop feeling like a crisis every single year.

What’s happening this week—and what it means for patients

The key point: the NHS is still providing urgent and emergency care during the strike, but less urgent care will wait longer, and some routine appointments may be rescheduled.

Industrial action by resident doctors began at 7am on 17 December and runs until 7am on 22 December. Resident doctors (previously called junior doctors) make up around half of all NHS doctors and can have up to 8 years’ hospital experience depending on specialty. When that much of the medical workforce is reduced, the service has to prioritise.

Don’t self-cancel—most appointments still go ahead

NHS England’s message is blunt for a reason: attend your appointment unless you’re told not to. The hidden cost of delayed care is real. A missed cancer referral, an unreviewed medication change, or a postponed post-op check can turn an avoidable problem into an emergency.

If the NHS needs to reschedule, it should happen in the interests of patient safety—not as a default.

Use the right front door: 111 online, pharmacy, GP, then A&E

The best “winter reform” patients can use today is choosing the right access route. The NHS is asking people to use:

• 999 or A&E for emergencies (chest pain, stroke signs, severe breathing difficulty, major trauma)
• 111 online for urgent but not life‑threatening issues, so you can be directed to the right service
• Your pharmacist or GP for many common winter illnesses, medication questions, minor infections, and flare-ups

This isn’t about gatekeeping; it’s about flow. When A&E becomes the default option for everything, the whole hospital slows down—ambulance handovers, bed availability, and discharge all get worse.

Flu is the multiplier—and vaccination is the fastest pressure-release valve

The direct answer: vaccinating more people reduces hospital admissions, protects staff capacity, and keeps elective care moving.

During winter pressure, flu doesn’t just add patients. It adds uncertainty: sudden spikes, more respiratory complications, and infection control measures that limit bed use. That’s why the NHS has been pushing flu vaccination hard—through GP sites, pharmacies, schools, and pop‑up clinics in community settings such as shopping centres, sports matches, and Christmas markets.

NHS England reports:

• 451,275 flu vaccines delivered in the first week of December 2025
• Up ~28,000 versus the equivalent week in 2024
• More than 17.4 million flu vaccines delivered so far this season
• ~170,000 more than this time last year
• Over 60,000 frontline healthcare workers vaccinated so far

That last figure matters. When staff are unwell, the NHS loses capacity twice: fewer clinicians available and more pressure on the remaining workforce.

“Last chance before New Year” isn’t marketing—it’s timing

The NHS is urging eligible people to get vaccinated now to be protected over the New Year period. Flu vaccines take time to build protection, and the weeks around Christmas and New Year are exactly when:

• GP access can be patchier
• family mixing increases transmission
• vulnerable relatives are visited more often
• hospitals are already under strain

If you’re eligible and haven’t had your jab, this is one of the most practical things you can do to reduce your personal risk and the NHS’s winter load.

A patient-friendly way to think about vaccination and NHS sustainability

Here’s a line I come back to: every preventable admission is a bed that stays available for the non-preventable ones.

NHS reform debates can get abstract—funding formulas, workforce pipelines, estate strategy. Vaccination is different. It’s immediate, measurable, and it protects both individuals and system capacity. If your goal is fewer waiting list delays and fewer cancelled operations, flu vaccination is part of that story.

The strike isn’t the story—system resilience is

The key point: strikes expose weak points; they don’t create them.

This is the 14th round of resident doctors’ strikes since March 2023, with 59 days of disruption. Each round forces the NHS into the same difficult triage:

• protect emergency and life‑saving care
• redeploy senior clinicians
• postpone lower‑risk activity
• accept longer waits for non-urgent cases

The problem is that winter pressure plus industrial action becomes a predictable crisis because the system has too little slack.

What “capacity” actually means in NHS reform

When people say “increase NHS capacity,” they often picture more buildings or more staff (both important). In practice, winter capacity is also about how quickly the system can move patients through the pathway safely.

Capacity is:

• Beds that can be used (not closed due to infection control constraints)
• Staff available to staff those beds (including sickness cover)
• Diagnostics throughput (tests that unblock discharge or decisions)
• Social care and community capacity (so discharge isn’t delayed)
• Digital triage and routing (so the right patients reach the right service)

If any one of these fails, you get bottlenecks. And bottlenecks are what make patients feel like “the NHS has stopped.”

The most expensive problem: delayed care and delayed discharge

When patients avoid care because they assume services aren’t available, they often return later—sicker. That creates:

• more complex treatment
• longer length of stay
• higher risk of complications
• slower elective recovery

Meanwhile, when medically fit patients can’t leave hospital due to gaps in social care, transport, or community support, beds stay blocked. That knocks-on into cancelled surgery and longer A&E waits.

If you care about NHS waiting lists, you should care about discharge pathways and community capacity. They’re not side issues—they’re the gears.

Practical guidance for patients during strikes and flu surges

The direct answer: keep your planned care on track, protect yourself from flu, and use services in a way that reduces avoidable escalation.

Here’s a checklist that’s genuinely useful over the next two weeks.

If you have an appointment booked

1. Attend unless contacted to reschedule.
2. Keep your phone handy (unknown numbers may be hospital teams).
3. Bring an updated medication list (or photos of labels).
4. If you’re unwell with respiratory symptoms, call ahead so the clinic can advise on infection control.

If you become unwell

• Use 111 online for urgent advice and direction.
• Use pharmacy first for many winter problems (coughs, sore throat, minor infections, medication queries).
• Call your GP practice if symptoms persist, you’re high-risk, or you’re worsening.
• Use 999/A&E for emergency warning signs.

If you’re caring for someone vulnerable

• Check they’ve had their flu vaccination if eligible.
• Make sure they have enough regular medication to cover holiday closures.
• Watch for early deterioration: confusion, reduced intake, breathlessness, or a sudden functional drop.

A simple reform-friendly habit: keep a one-page “health summary” for vulnerable relatives—conditions, meds, allergies, baseline function, and key contacts. It saves time when services are under pressure.

What longer-term NHS reform should focus on (so winter stops being a crisis)

The key point: the NHS doesn’t need a single magic fix. It needs a set of operational reforms that add resilience when demand spikes.

If you want fewer cancelled operations, shorter waits, and less winter chaos, these are the areas that consistently pay off.

1) Smarter demand management (without blaming patients)

Expand and standardise high-quality triage and routing so patients can get to the right setting quickly—especially when staffing is disrupted. This includes consistent use of 111 pathways, local urgent treatment centres, and pharmacy-first services.

2) Workforce planning that absorbs shocks

A service where resident doctors are around half the medical workforce needs contingency that doesn’t rely on heroics. That means:

• realistic staffing buffers
• better retention (less burnout-driven exits)
• predictable rota design
• protected training that doesn’t collapse every winter

3) Community capacity that makes discharge real

You can’t fix hospital flow from inside the hospital alone. Community nursing, reablement, intermediate care beds, and social care availability are direct levers on A&E waits and elective backlogs.

4) Vaccination as infrastructure, not a seasonal campaign

Pop-up clinics in community venues are a smart move because they reduce friction. The next step is to make vaccination delivery a year-round system capability: consistent data, reminders, and easy access, not a December scramble.

Where this leaves us—and what you can do next

The NHS is asking people to do two things during the resident doctors’ strike and flu surge: keep coming forward for care and get vaccinated if eligible. That advice is right. Delaying care is one of the fastest ways to turn a manageable health problem into a hospital admission.

But if we’re serious about Healthcare & NHS Reform, we should be honest: winters like this are no longer a surprise. They’re a predictable collision of seasonal illness, tight bed capacity, and workforce fragility. A resilient NHS is one that can take a hit—flu spikes, staff sickness, industrial action—and still keep routine care moving.

If you’re working on NHS transformation, commissioning, digital triage, workforce strategy, or vaccination delivery, now is the time to ask a tougher question: what would it take for next December to feel boring?