Winter demands are putting emergency services under enormous pressure, says Sir Bruce Keogh.

Speaking at a conference at the King’s Fund, the medical director of NHS England said “the system is creaking” with the onset of winter.

He commented that A&E services are stretched as increasing numbers of patients seek medical help during the winter months.

This has been evidenced at Gloucestershire’s Hospital Trusts which was recently unable to find beds for up to sixty patients, prompting a major incident to be declared.

Ambulance services are also struggling to cope with the demand, despite the government providing the NHS with an extra £300m in funding, bringing the total winter budget to £700m.

The London Ambulance Service said that the week commencing 8 December was their busiest ever, with a 15% increase in serious cases compared with the same week last year. It has been forced to call in help from other ambulance services, such is the strain.

Director of operations Jason Killens said: “We have introduced a range of measures to help manage demand, including not sending an ambulance to more callers with less serious injuries and illnesses and instead giving them additional telephone advice or referring them to NHS 111.”

However, the role of the NHS 111 has been queried by Dr Clifford Manning, president of the College of Emergency Medicine.

He suggested the NHS helpline could actually be having an adverse effect on A&E services, as operators often direct patients to A&E or call an ambulance on the patient’s behalf.

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