What is it about?

End of life represents a period of high health service demand. This article investigates strategic and operational tactical planning for winter demand. Following a period of lower deaths which commenced in early to mid-2018 a shift to higher deaths has been sweeping across the entire UK during 2019. Scotland and the North West of England have seen the earliest shift up in deaths. A similar shift to higher deaths in early 2014 is shown to be linked to very high winter deaths and health service demand in the 2014/15 winter. Infectious granularity therefore plays a major role in winter demand.

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Why is it important?

This is important because it explains why some winters are worse than others, and why some locations are affected worse than others. An outbreak of the mystery agent often occurs before the onset of seasonal influenza and appears to potentiate the effects of influenza. Outbreaks of the mystery agent occur around the world (see supporting research at http://www.hcaf.biz/2010/Publications_Full.pdf) and have a characteristic case mix relating to the associated ED attendances and hospital admissions.


This is part of a far wider series on the spatial spread of a new kind of disease outbreak and its implications to health service demand planning. For the winter of 2019/20 spread of the new agent commences in Apr-19 in Scotland and NW England, July-19 NE England, Aug-19 East Midlands and East of England, Sep-19 Yorkshire and Humber, etc. Best estimate is a 5% to 10% shift up in deaths sweeping across the UK from April-2019 onward. Influenza will therefore build on top of the earlier outbreak of this other agent. Both may compliment each other in the lung.

Dr Rodney P Jones
Healthcare Analysis & Forecasting

Read the Original

This page is a summary of: Will the winter of 2019/20 have unusually high service demand? Part 2: Strategy, Journal of Paramedic Practice, December 2019, Mark Allen Group,
DOI: 10.12968/jpar.2019.11.12.538.
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