Elective cancellations during a flu surge are accelerating as hospitals pause planned procedures in response to sharply rising flu admissions. NHS England’s winter data showed an average of 2,660 patients per day in hospital with flu last week, 55% higher than the week before and the highest for early December, driving difficult capacity choices across trusts. In addition, UKHSA surveillance confirms rising influenza activity, with increasing hospitalisation, even before the Dr strike we are now in, some paediatric services had already postponed operations in some units as respiratory viruses push critical care to the brink.

From ICE Creates’ vantage point, working alongside systems through previous winters, the core question isn’t whether cancellations are “right”, but how to minimise the need for them while protecting safety and equity. Four practical principles help:

1. Reduce avoidable demand upstream.

Targeted vaccination and clear self‑care guidance matter most when capacity is tight. Behaviourally informed campaigns should be segmented depending on target audiences and their specific barriers to support blanket awareness campaigns which often struggle to overcome vaccine hesitancy, competing priorities and practical barriers within specific communities. Use simple prompts and localised narratives across trusted local channels to drive uptake and reduce preventable admissions.

2. Empower self‑care.

Give people clear, plain‑English guidance for common winter illnesses: when to self‑manage, when to use Pharmacy First or NHS 111 online, and when urgent care is appropriate. Use myth‑busting content, simple symptom checklists and community‑facing moderation to reduce anxiety and steer demand to the most appropriate service.

3. Shorten length of stay safely.

Flu pressure magnifies the importance of discharge confidence. Family friendly information, myth busting and practical checklists enable earlier, safer transitions home and reduce readmissions, protecting general and critical care beds without compromising quality. Earlier, safer transitions home reduce readmissions and protect general and critical care beds, without compromising quality.

4. Support staff and leading community organisations with how to navigate often difficult conversations.

Staff and public dialogue shapes behaviour as much as any campaign. Equipping teams with techniques to listen, reflect, and co-create next steps builds trust and accelerates compliance, from vaccinations to discharge planning. Embedding these micro-skills across pathways turns communication into a capacity tool, not just a courtesy.

The guiding principle is clear: protect those at highest risk today while safeguarding long‑term outcomes for those awaiting planned care. With targeted prevention, confident discharge, and better conversations, systems can temper winter peaks and reduce the collateral harm of elective cancellations, even in a year when flu is rising fast and the peak isn’t yet in sight!

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See some over our previous vaccination work: https://icecreates.com/our-work/vaccine-conversation-training-community-teams/

Download our Vaccination summary: https://icecreates.com/vaccination-executive-summary/