The NHS in the North West is facing an earlier than usual spike in viruses as winter draws in, increasing pressure on hospitals
People have been urged to use health services "responsibly" and consider going to a pharmacy or NHS 111 for help where appropriate
It follows five days of strike action by resident doctors and record numbers of people waiting 12 hours or longer to be admitted to hospital from A&E
Hospitals and GPs are trialling new systems to speed up patient treatment, including caring for more people in the home
A flu vaccination drive has also kicked in to offer protection to another 300,000 people in the region
Last month the NHS moved to a ‘total triage’ system where all requests for appointments online or by phone are immediately assessed by GPs or nurses.
BBC North West Tonight visited a GP practice in Lancashire to see how the system is going.
Leanne Harper
BBC Radio Merseyside
It's another busy day at Southport and Formby Hospital for the 3,500 staff and volunteers based here.
BBC Radio Merseyside has been speaking to them about the challenges of winter, as cases of flu rise while pressure remains on bed spaces.
Head of Operations, Joanne Marsden spoke to the team about waiting times in A&E : “We’ve had some long waits overnight where we’ve been around the three to four hour mark.
"And that’s far too long for us. Yesterday we were around the two hour mark for some patients. But our most unwell will be seen in a matter of minutes.”
Will Adams is the manager of ward 7B, which specialises in care for older patients.
He said: "The challenges of winter, and the cases of flu and Covid as they rise, bring added challenges to my team to be able to deliver the care we want.
"It’s a great challenge but we have an amazing team, and we always say on Ward 7B, how we measure our success is if we would be happy for our nearest and dearest to receive that care. That’s the level we work to.”
Ellie Browning
BBC Radio Lancashire
BBC Radio Lancashire has been live from the discharge lounge at Royal Preston Hospital, where we have been speaking to Sarah Morrison, the deputy chief executive and the chief nursing officer.
She spoke about £2bn plans for a new Royal Preston Hospital and said: “It's really, really positive that we're part of that new hospital programme, albeit it is further away than what we would want it to be."
"The fact that we are an active member of that programme is really motivating for us and it will be absolutely critical that we remain on that group so that we can get to the point where we've got a new hospital in the future.”
Construction work on a replacement for Royal Preston Hospital is expected to start between 2037 and 2039.
Mat Trewern
BBC Radio Manchester
I’m at Wythenshawe Hospital in South Manchester, which is a leading centre for heart and lung transplants, treating patients across the North West and beyond.
Fun fact - surgeons here carried out the hospital’s first heart transplant back in 1987.
On a chilly morning, the main out-patients department here at Wythenshawe is quickly coming to life. The early morning cleaners have been through, getting the unit ready for another day.
Patients are arriving for their appointments, many asking staff for directions to find exactly where in the hospital they need to be. And the out-patients café is open, with nurses and patients queuing for their coffee and snacks.
Paul Joynson-Robbins, the hospital’s director of nursing told me they had a “really busy” day yesterday.
“We had more than 400 patients come through our Accident & Emergency Department for treatment.”
“But the big one we’re preparing for this winter is flu. We have a very active flu campaign, vaccinating our staff and the vulnerable patients in our care.”
Catch up on all the latest at BBC Radio Manchester.
More people have been coming to North West hospitals with viruses like flu and other respiratory conditions "'much earlier" than in previous years, according to the NHS.
Dr Zahid Chouhan, a GP based in the region, said viruses "are up, and then on top of that you have elderly people, it’s the winter, people are getting cold, they have already got chronic illnesses".
"So it’s a mixture of loads of factors."
He said this was putting pressure on hospital care and the availability of beds.
Quote MessageJust put your self into a patient’s shoes and think, you’re going to hospital, you are going with a hope that you will be treated, you will be given the care you need. And then actually you go and sit there, if you’re lucky, on a chair, if you’re a bit more lucky, it might be on a trolly in a corridor.
Dr Zahid Chouhan, GP
Annie Knowlson
BBC North West Tonight
In hospitals in Cheshire and Merseyside, over 45% of people were waiting more than 4 hours to either be admitted to hospital or discharged from A&E.
In Greater Manchester, this figure was 43%, while in Lancashire and South Cumbria, it was 38%.
Wait times can be a good indication of how full a hospital is, and long waits for a bed are becoming increasingly common.
Last month in Warrington and Halton, just over 46% of admissions waited over 12 hours or more for a bed.
In Tameside, this figure was 28%, and in East Cheshire, 24%.
As the nights draw in and the temperatures drop, things begin to heat up for an NHS already struggling with the pressures of rising demand, long waits in A&E, ambulance delays, and industrial action.
So are health services in the North West ready to deal with an expected spike in people coming to hospital with flu and other respiratory illnesses over winter?
We will be hearing throughout the day from the doctors, nurses and other emergency services staff about how they are trying to meet that challenge.
Our BBC North West teams are out today speaking to staff in hospitals in Greater Manchester, Merseyside and Lancashire and we'll be bringing you everything you need to know about our NHS is preparing for winter.
Image source, PA MediaThe NHS is already seeing a spike in viruses as the cold weather arrives