Britain’s National Health Service (NHS) is facing what officials are calling a "historic crisis" as flu hospitalizations soar to record levels, a more severe strain of the virus sweeps the country, and a looming doctors’ strike threatens to tip the system into further chaos just weeks before Christmas. According to NHS England, nearly 1,717 patients a day were admitted for flu last week—a staggering figure that represents a 56% increase over last year and more than ten times the number seen at the same time in 2023.
Medical authorities and public health experts are sounding the alarm as the UK grapples with what NHS chief executive Sir Jim Mackey described as "a tidal wave of illness". The crisis comes as the country faces an "unprecedented flu wave," with no sign of a peak in sight, and the health service under immense pressure from both seasonal viruses and industrial action by resident doctors.
In a statement, NHS England warned: "The NHS is facing an unprecedented flu wave this winter with 'no peak in sight yet' according to England's top emergency care doctor. Latest figures show an average of 1,717 patients were in a hospital bed every day last week because of flu—the highest on record for this time of year." The UK Health Security Agency (UKHSA) echoed these concerns, reporting that the proportion of positive flu tests jumped from 11.6% to 17.1% between November 24 and 30, while hospital admissions for influenza surged from 4.78 to 7.79 per 100,000 population in the same period.
Officials have identified a particularly troublesome culprit: a "drifted" influenza A(H3N2) strain, also known as "subclade K" or "super flu." This mutant variant is believed to be more infectious and severe than previous strains, with Professor Nicola Lewis, director of the World Influenza Centre at the Francis Crick Institute, explaining to the Daily Mail: "We haven't seen a virus like this for a while, these dynamics are unusual. H3 is always a hotter virus, it's a nastier virus, it's more impactful on the population."
Children aged five to 14 are driving much of the increase, but the virus is now having a greater impact on adults, particularly those over 65. Admission rates are highest among people aged 85 and over, at 40.0 per 100,000, followed by 75-84 year-olds (21.4) and children under four (21.2). In Scotland, Public Health Scotland reported that lab-confirmed flu cases more than doubled in a week, with hospital admissions rising 70%.
The situation is exacerbated by the timing of a planned five-day strike by resident doctors, scheduled from December 17 to December 22. The British Medical Association (BMA) has blamed the government for failing to make progress on pay and working conditions, while Health Secretary Wes Streeting labeled the strike "irresponsible and high risk given the pressures we're seeing in the NHS." NHS England chief executive Sir Jim Mackey went further, saying the timing "feels cruel" and could cause "mayhem" during an already intense winter season. He told a board meeting: "The planned strike action has caused a genuine and palpable feeling of anger, frustration and exasperation among colleagues. I really do hope we can find a way of avoiding this."
The public appears divided on the issue, with new YouGov polling showing that 53% of Britons oppose the upcoming strike, compared to 38% in support. NHS Providers chief Daniel Elkeles urged both sides to resolve the dispute ahead of Christmas, warning that the NHS is "constantly combating a tidal wave of flu alongside other seasonal illnesses."
Beyond the immediate strain on hospital beds, the surge in flu cases has prompted renewed calls for preventive measures. Virology experts and health leaders are now urging Britons to wear face masks in crowded or poorly ventilated spaces—particularly if they are elderly, immunocompromised, or in contact with vulnerable people. The UKHSA reissued guidance stating that masks "continue to be a useful tool in limiting the spread of respiratory viruses in some situations," especially as the country faces rising cases of not just flu, but also Covid-19 and respiratory syncytial virus (RSV).
Several NHS trusts across England, Scotland, and Wales have reintroduced mandatory or recommended mask policies in high-risk hospital areas. For example, United Lincolnshire Teaching Hospitals NHS Trust has asked patients, visitors, and staff to wear face coverings in certain wards, while similar measures have been imposed in hospitals in Shropshire, Oxfordshire, North London, and parts of Wales and Scotland. National mask mandates ended in 2022, but local trusts now have the authority to make their own rules as needed.
Professor Julian Redhead, national medical director for urgent and emergency care, urged the public: "With just a couple of weeks left to ensure maximum immunity from flu for Christmas Day, I urge anyone eligible to come forward to get their jab." Flu vaccines are available for everyone aged 65 and over, those in clinical risk groups, care home residents, pregnant women, close contacts of immunosuppressed individuals, frontline health and social care workers, and children. Dr. Jamie Lopez Bernal, UKHSA consultant epidemiologist, warned: "Nobody wants anyone in their family, especially young children, to spend Christmas in hospital. The best defence against this is a vaccine, but time is running out as it can take up to two weeks from vaccination for your body to build maximum protection."
Despite preparations, the NHS is struggling to keep pace. The winter situation report showed that 30% of patients arriving by ambulance last week waited at least 30 minutes to be handed over to A&E teams—a slight improvement on last year but still a worrying sign. Rory Deighton, acute director at NHS Confederation, said: "It is clear that the flu season has hit much earlier and much harder than in previous years, piling pressure onto NHS services which have already had one of their busiest summers ever."
Amid the crisis, there are also concerns about the NHS workforce. The Nursing and Midwifery Council (NMC) reported a nearly 50% drop in the number of internationally educated nurses and midwives joining the UK register compared to last year. Experts warn that tighter visa rules and efforts to cut immigration could deepen staff shortages at a time when tens of thousands of nursing jobs remain unfilled.
For the elderly, the National Audit Office highlighted troubling gaps in follow-up care for those diagnosed with frailty, with only 16% receiving a medication review and 18% a falls risk assessment after diagnosis. An NHS spokesperson acknowledged the need for improvement, stating: "We will use this report's findings to help ensure that we can provide care for an ageing population in a sustainable way."
There is, at least, a glimmer of good news: hospitalizations for norovirus and Covid-19 are lower than in previous winters, with 263 beds filled by patients with norovirus-like symptoms last week (down from 756 a year ago) and 825 beds occupied by Covid-19 patients (down from 1,390).
As the UK heads into the holidays, the message from health officials is clear: get vaccinated, wear a mask where appropriate, and stay home if you’re unwell. With the NHS under such intense strain, every precaution counts.
