For the first column of 2026, Michael Whitcombe, Deputy Chief Operating Officer, reflects on the typical busiest week of the year and the teamwork involved in keeping our services moving during the additional demand…

Earlier this week, I wrote in the Daily Email that the early part of January is traditionally the busiest time in the NHS. This year has been no different. In fact, on Monday 5 January we saw the highest attendances on record across our Emergency Department, Minor Injury Units at Kingsbridge and South Hams, and the Urgent Treatment Centres at Cumberland and Dartmoor.

Since Dartmoor came online in October, it has not simply been a case of diverting patients away from the Emergency Department. Instead, we have seen an overall increase in attendances across our urgent and emergency care footprint. So on Monday, whilst we were all dealing with the cold snap and ice, the total attendances reached 718, a record for us.

This significant increase was driven in part by the usual post-Christmas surge, but was compounded by icy conditions across the region, which led to a rise in fractures and neck of femur (NOF) injuries presenting at our units. Sue Timmins, our Directorate Matron for Orthopaedics, reported that from Tuesday morning onwards there were further NOF admissions, resulting in Sharp and Shaugh Wards quickly filling up.

As the week progressed, attendances returned closer to our normal average levels of around 550 – 600 attendances across all sites. However, that early surge created a substantial amount of additional work for colleagues working right across our services and we are acting tirelessly to reduce the escalation spaces we have found ourselves in.

One colleague working as part of this wider system is CJ, a Site Porter. Our portering team are among those who feel pressure immediately when demand increases. Simply, more patients coming into hospital means more patients to move. On Monday alone, CJ moved 33 patients across the site, including transfers to the Discharge Lounge.

Moving patients to the Discharge Lounge is a critical part of keeping patient flow working effectively. It frees up space within our urgent and emergency care areas for patients waiting to be seen and enables ambulances to offload patients who need our care. Highlighting CJ’s contribution is also an important way of recognising the vital role our portering colleagues play as a linchpin of the hospital system, supporting patient safety, flow and dignity, while enabling clinical teams to focus on care delivery.

While attendances often focus on patients coming into our services, increased demand has a knock-on impact across many other teams too. Our clinical and site teams face these initial pressures, working to move patients through the system safely and compassionately, and that affects every other area of the hospital. More people means more equipment used, more bed spaces to clean, more linen, more information being gathered and reported – our whole Trust ecosystem has to react 24 hours of every day.

So I wanted to take this week’s Friday Five to personally thank each and every one of you who continues to work tirelessly for patients and for your colleagues. While we cannot control how many people need our help, we can control the experience they have while they are with us and the way we work together to deliver the best possible care for patients and their families.