NHS preparing for 'significant excess deaths' this winter

The documents state: “The resilience planning officers of North and South Lanarkshire are working alongside local undertakers to ensure there is sufficient ‘pace’ of funeral services – both burials and cremations – to support the eventuality of a significant excess of deaths over the winter period.

“Additional mortuary capacity identified for Covid is still in place and will continue to be available over the winter period.”

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A spokesman for the health board insisted that this was a routine part of winter resilience planning undertaken every year, but it comes amid fears that a resurgence of flu and Covid on top of the cost-of-living crisis could wreak havoc on an already buckling NHS.

During the past six months alone, from mid-April to mid-October, the number of people dying in Scotland has been running 10 per cent above average for the time of year.

Of the 2,828 excess deaths recorded, non-Covid illnesses such as heart attacks, strokes or dementia are responsible for more than half.

Flu rates are currently low but roughly twice what they would normally be for the time of year, with public health experts anticipating a much earlier surge in the virus following two successive winters where it virtually disappeared.

The 2022/23 flu season has begun early (red line to left) with incidence on the increase and higher than usual for the time of year (Image: PA)

Charities and researchers have also warned that the soaring costs of food and fuel could drive up mortality as vulnerable people cut back on meals and heating to save money. 

Soumen Sengupta, director of health and social care for South Lanarkshire, said: “Every winter brings pressures on our health services with an increase in norovirus, colds and flu and other winter illnesses.

“This year may be even more challenging having to deal with any potential increase in the number of Covid-19 cases.

“The Lanarkshire approach to winter planning involves all parts of our health and social care system including GP surgeries, the primary care out of hours service, pharmacies, social care and acute hospitals.

“Each year, NHS Lanarkshire works with partner organisations including the Scottish Ambulance Service, NHS 24 and North and South Lanarkshire Councils to ensure all eventualities are planned for.

“As is the case every year, we are working closely with our local authorities to make sure there is sufficient mortuary and funeral provision in the event of unexpected increased deaths.”

It comes as a report revealed that last year saw Scotland record its third highest winter death toll since the century began.

Total deaths in winter in Scotland since 1951/52 versus the four-month periods before and after (Image: NRS)

Between December 2021 and the end of March this year, there were 22,055 deaths from all causes.

This was down from 23,370 during the first winter with Covid in 2020/21, and 23,153 in 2017/18 - an exceptionally high flu season.

Otherwise, last winter saw the highest mortality since 1999/2000 - when 23,379 deaths were registered.

The report, by National Records of Scotland, notes that excess winter mortality last year was comparatively low, but only due to “unusually high” numbers of deaths from August to November 2021.

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Excess mortality in winter is calculated by comparing the total number of deaths from December to March against the average for the four months before and after winter.

In 2021/22, there were 1,320 excess winter deaths compared to an average of around 2,600 for the past decade.

However, this was skewed by the 21,679 deaths registered in August to November 2021 - the highest number recorded during any autumn period since counting began in 1951/52.

NRS said these were "partly attributed to Covid-19".

However, it also overlapped with the period where A&E performance began to steeply deteriorate - a problem closely associated with excess deaths.

The most common causes of the 1,320 excess winter deaths last year were dementia and Alzheimer's disease, followed by cerebrovascular disease - such as brain haemorrhages.

READ MORE: More than half of excess deaths not caused by Covid for first time since start of pandemic 

Covid was the underlying cause of 60 of the 1,320 additional deaths, compared to 80 caused by pneumonia and 50 due to accidental falls.

Julie Ramsay, Head of Vital Events Statistics at NRS, said: “The seasonal increase in mortality can change substantially from winter to winter, but the long-term trend has clearly been downward.

"In the 1950s and 60s there was an average seasonal increase of over 5,200 deaths in winter.”

Covid rates appear to be on the rise again in Scotland, but winter boosters are being rolled out to the highest risk groups in a bid to reduce hospital admissions and deaths from the disease (Image: PHS)

In recent weeks, the prevalence of Covid appears to have ticked upwards again in Scotland with an estimated one in 35 infected by the first week in October.

Professor Christina Pagel, a healthcare mathematician, said the current wave appears to be driven by waning immunity and increased mixing indoors, but that several newer Omicron sub-variants - BQ.1, BQ1.1, and BF.7 - made up 17% of sequenced cases in the UK by early October.

She said: "At some point they will become dominant and likely drive a modest wave, but we're seeing these more immune-evasive variants hitting a more immune population as we're boosting, so it's not really clear how those two things are going to play off against each other."

To date, 74% of over-65s and 85% of elderly care home residents in Scotland have received their winter Covid booster, though this dips to just 20% for social care workers.

Uptake of the flu vaccine is also high among older adults - at 70% for over-65s and 85% for elderly care home residents - but is just 13% so far among clinically vulnerable under-65s.