What is it about?

Marginal changes in NHS workload respond to the number of deaths, especially in the winter. Deaths are linked to workload via the nearness to death effect in which around half of a person's lifetime acute admissions occur in the last year of life, and more specifically in the last 6 months of life. Evidence is presented to show that on/off switching in the months before winter may regulate winter deaths.

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Why is it important?

If switch-on in a location can be determined before the winter then plans can be put in place for the likely higher end-of-life related workload in the coming winter.

Perspectives

It is looking increasingly likely that a bad influenza outbreak only occurs if switch-on of deaths has occurred before the winter. Clearly this needs to be a matter of urgent research. As to the nature of switch-on this appears to be a shift in the immune state of susceptible members of the population. Immune switching to a new steady state has been observed to occur in Gulf War Illness and several other diseases and also occurs in pregnancy as the mother's body adjusts to implantation of the foetus. This is part of a far longer study available at http://www.hcaf.biz/2010/Publications_Full.pdf

Dr Rodney P Jones
Healthcare Analysis & Forecasting

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This page is a summary of: NHS winter workload and on/off switching of deaths, Journal of Paramedic Practice, April 2019, Mark Allen Group, DOI: 10.12968/jpar.2019.11.4.172.
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