NHS Winter Crisis 2025: Record Flu & A&E Pressures Interview Guide

As a practising GP in London, I am currently seeing the full force of the NHS winter crisis firsthand. The latest data is stark: we are facing a record-breaking flu season with hospital admissions over 50% higher than last year, compounded by a staggering number of patients attending A&E for minor conditions like sore throats and earaches.

For aspiring medical students, understanding these specific pressures - from the 200,000 avoidable A&E visits to the impact of the 'Pharmacy First' scheme - is absolutely vital for your interviews.

Quick Answer: The NHS is currently facing a "historic winter crisis" with flu admissions rising by 56% compared to 2024. This pressure is exacerbated by over 200,000 avoidable A&E visits for minor ailments that could be treated elsewhere. To manage this, NHS leaders are urging the public to use Pharmacy First and NHS 111, while expanding primary care access through the ARRS scheme.

What are the current 'Winter Pressures' and Flu Statistics?

Winter pressures refer to the surge in demand the NHS faces during colder months, primarily due to respiratory illnesses like flu, COVID-19, and RSV.

This year, the figures are particularly alarming. Recent NHS data shows an average of 1,717 patients were in hospital with flu last week alone - a figure that is 56% higher than the same point last year (where it was 1,098). Even more concerning is that critical care admissions for flu have nearly doubled.

From my perspective on the frontline, this isn't just about numbers. It means that nearly 2% of all hospital beds are now occupied by flu patients. When you combine this with the fact that bed occupancy is already consistently above safe levels, hospitals are being stretched to breaking point. For you as an applicant, this is a prime example of the NHS Bed Shortages and "capacity vs demand" challenge you may be asked to discuss in a medicine interview.

Key Takeaway: Flu hospitalisations are at a record high (1,717/week), hitting earlier than usual and occupying vital bed space needed for other emergencies.

Why are patients attending A&E for minor ailments?

A significant factor contributing to A&E overcrowding is the attendance of patients with minor conditions that could be treated elsewhere.

NHS England recently released data revealing that between November and February, there were over 200,000 A&E attendances that could have been managed by other services. The data breakdown is quite shocking:

• 96,998 visits for sore throats

• 83,705 visits for earaches

• 6,382 visits for nasal congestion

As a GP, I often get asked by students: "Why do patients go to A&E for a sore throat?" The answer is complex. It often boils down to a lack of health literacy or difficulty accessing GP appointments. When patients cannot get through to their surgery on the phone - a common frustration - they often perceive A&E as their only "open door".

However, this misuse diverts critical resources. Every doctor attending to a sore throat in A&E is one less doctor available for a cardiac arrest or major trauma. This is a classic Resource Allocation ethical dilemma you might face in an MMI station.

Key Takeaway: Over 200,000 A&E visits were for minor issues like sore throats or earaches, often driven by poor health literacy or perceived lack of GP access.

How does the 'Pharmacy First' scheme help reduce pressure?

Pharmacy First is a government initiative allowing pharmacists to treat seven common conditions without a GP appointment, aiming to free up 10 million GP appointments a year.

This scheme is a crucial part of the solution to the A&E crisis. Instead of waiting for a GP or sitting in A&E for four hours for a sore throat, patients can now walk into a pharmacy and receive treatment - including antibiotics if necessary - for conditions such as:

• Sinusitis

• Sore throat (which caused nearly 97,000 A&E visits!)

• Earache

• Infected insect bites

• Impetigo

• Shingles

• Uncomplicated urinary tract infections (UTIs) in women

• 
  

In my clinics, I now regularly refer patients to this service. It is a fantastic example of a multidisciplinary team (MDT) working, utilising the skills of pharmacists to reduce the burden on doctors. When discussing solutions to NHS pressures in your interview, mentioning Pharmacy First shows you are up-to-date with the current NHS strategy.

Key Takeaway: Pharmacy First empowers pharmacists to treat seven common conditions, directly reducing unnecessary GP and A&E visits.

What is the ARRS scheme and how does it improve GP access?

The Additional Roles Reimbursement Scheme (ARRS) provides funding to Primary Care Networks (PCNs) to recruit additional staff like physiotherapists, paramedics, newly qualified GPs, and pharmacists.

One of the main causes of A&E misuse is the difficulty in getting a GP appointment. The ARRS scheme aims to solve this by diversifying the workforce. It means that when a patient calls my surgery with back pain, they might see a First Contact Physiotherapist instead of me. If they have a minor injury, they might see a Paramedic Practitioner.

Recently, the government has also expanded ARRS to include newly qualified GPs, helping to keep more doctors working in primary care. This is a critical point to mention if you are asked about the GP Shortage and Crisis or workforce planning. It shows you understand that "seeing a doctor" isn't always the only or best option for patient care.

Key Takeaway: ARRS funds roles like physios and paramedics (and also newly qualified GPs) in GP practices, expanding the workforce and improving patient access to the right professional.

How do Resident Doctor strikes impact winter planning?

Industrial action by resident (junior) doctors significantly reduces the NHS's capacity to handle winter surges by removing a large portion of the workforce.

NHS bosses have stated that planning for strikes alongside record flu numbers is "cruel" and causes "mayhem". While the Junior Doctor Strikes are driven by valid concerns over pay restoration and retention, the timing during winter creates a "perfect storm".

During strike days (such as the planned walkouts from December 17-22), consultants step down to cover emergency care, which leads to thousands of elective (planned) operations being cancelled. This exacerbates the NHS waiting list backlog. In an interview, you must be able to appreciate both sides: the right of staff to fair pay as advocated by the British Medical Association (BMA), and the impact of strikes on patient safety during a crisis.

Key Takeaway: Strikes during winter reduce workforce capacity, leading to cancelled operations and increased pressure on remaining staff during flu peaks.

Medical School Interview Questions: Winter Pressures

Discussing winter pressures requires you to balance empathy for patients with a logical understanding of NHS systems and resource management.

If you are applying to medical school this year, there is potential for you to face "Hot Topic" station on this. Interviewers are looking for more than just regurgitating facts; they want to see critical thinking.

Potential Interview Questions To Get You Thinking:

1. "The NHS is facing record demand this winter. What measures would you implement to reduce A&E waiting times?"

2. "Should patients be charged for attending A&E with minor conditions like sore throats? Discuss the ethical implications of this."

3. "How can the NHS improve public awareness of services like Pharmacy First?"

4. "Is it ethical for doctors to strike during a winter flu crisis? Explain your reasoning."

Why expert help matters:

While reading articles like this is a great start, framing these answers under pressure is a different skill. Many students struggle to balance the arguments or get flustered by follow-up questions. This is why I helped design TheUKCATPeople's Medicine Interview Tutoring to be the most comprehensive preparation available.

Unlike generic mock interviews, our 1-to-1 sessions simulate these exact "Hot Topic" stations, giving you personalised feedback on your delivery and ethical reasoning. If you want to ensure you can discuss the flu crisis with the confidence of a future colleague, I strongly recommend booking a Free Strategy Consultation with us.

Key Takeaway: Practice answering questions on A&E misuse and strikes using a balanced, ethical framework – consider professional tutoring to perfect this skill.

Frequently Asked Questions (FAQs)

What are NHS Winter Pressures?

NHS Winter Pressures describe the predictable surge in demand on the health service during colder months. This is driven by a spike in respiratory illnesses like influenza, RSV, and COVID-19, alongside cold-weather injuries. These factors combine to increase A&E attendance and limit bed availability, often leading to "bed blocking" where patients cannot be discharged due to social care shortages.

How does the flu affect NHS waiting times?

Flu outbreaks significantly degrade hospital flow by filling beds required for elective surgeries. When bed occupancy exceeds safe levels (typically 85-90%), hospitals suffer from "exit block." This means A&E patients cannot be admitted to wards, causing dangerous delays in emergency departments and ambulance handover queues, as seen in the NHS Bed Shortages crisis.

What is the Pharmacy First scheme?

Pharmacy First is a strategic NHS initiative enabling community pharmacists to treat seven common conditions - including sore throats, sinusitis, and earaches - without a GP appointment. By allowing pharmacists to supply prescription-only medicines like antibiotics, the scheme aims to free up millions of GP appointments annually and reduce unnecessary A&E visits for minor ailments.

Can I go to A&E for a sore throat?

No, you should not attend A&E for minor ailments like sore throats or earaches unless you have difficulty breathing or swallowing. NHS guidance directs patients with these conditions to use NHS 111, local pharmacies, or Urgent Treatment Centres (UTCs). Misusing A&E for non-urgent issues diverts critical resources away from life-threatening emergencies like strokes or trauma.

What is the ARRS scheme in the NHS?

The Additional Roles Reimbursement Scheme (ARRS) provides funding to Primary Care Networks (PCNs) to recruit diverse specialists into GP practices. By hiring physiotherapists, paramedics, and clinical pharmacists, the scheme expands the Multidisciplinary Team (MDT). This improves patient access by ensuring they see the right professional for their specific need, alleviating the GP Shortage.

Why are there so many flu patients in ^the hospital this year?

The 2025 flu season is severe because it began a month earlier than usual, driven by a more virulent strain and lower population immunity. NHS data shows hospital admissions are 56% higher than last year. This surge is likely exacerbated by "vaccine fatigue" and lower uptake rates in vulnerable groups, leading to higher critical care requirements.

How do strikes affect patient safety in winter?

Strikes reduce the workforce capacity during critical periods, leading to the cancellation of thousands of elective procedures to prioritise emergency care. While the BMA Junior Doctor Strikes maintain emergency cover, NHS leaders argue that industrial action during a flu peak strains the remaining staff, potentially compromising patient safety due to reduced supervision and flow.

What should I read for my medical school interview?

You must stay updated on the NHS Long Term Workforce Plan, the impact of an ageing population, and the ethical implications of Medical Strikes. Reliable sources include the NHS England News section, the BMJ, and TheUKCATPeople's blog, which specifically analyses these topics for interview candidates.

How can I prepare for NHS Hot Topic interview questions?

To master these questions, you must move beyond facts to ethical analysis (e.g., discussing the Four Pillars). While reading is essential, practising verbal delivery is crucial. TheUKCATPeople's Medicine Interview Tutoring provides mock interviews with experts who can teach you to structure balanced, high-scoring answers for MMI stations on hot topics.