Professor John Robertson OBA

From Viral respiratory diseases in Scotland surveillance report published 27 November 2025 (Latest release):

Influenza levels continued to rise in Scotland in week 47, with a sharp rise in laboratory-confirmed cases (from 555 to 805) and hospital admissions (279 to 391), and higher test positivity (from 11.0% to 15.8%). All age groups are now affected at levels not previously seen this time of year. 

https://www.publichealthscotland.scot/publications/viral-respiratory-diseases-in-scotland-surveillance-report/viral-respiratory-diseases-in-scotland-surveillance-report-27-november-2025/

How are hospitals coping in Scotland and across the UK?

However, while admissions are elevated and systems are under strain, widespread declarations of “overwhelming” (e.g., critical incidents) are more prominent in England than in Scotland or Wales as of late November.

Why is that? In Scotland:

Admissions are high (peaking at 29 per 100,000), but the system appears more resilient so far, with no major surge in deaths reported. Officials cite 80% flu vaccine uptake among at-risk groups and enhanced hospital cleaning protocols as mitigating factors. Preparations include dedicated wards for winter viruses, and experts predict no “major flu deaths surge” if trends hold.

Is it Overwhelming?

Not fully yet, but it’s heading that way, especially in England where hospitals are “struggling to cope” with early surges and multi-virus pressures. Scotland and Wales show elevated cases but proactive measures (e.g., masking in Wales, high vax rates in Scotland) have prevented declarations of critical overload as of now.

Sources at: https://x.com/i/grok?conversation=1994362230238761150

What does the AI mean about NHS Scotland being more resilient?

This:

Scottish Government significantly widened access to free flu vaccine to give more than twice as many, per capita, protection from worrying new mutation

First, availability in England – you can get the free NHS flu vaccine if you:

• are aged 65 or over (including those who will be 65 by 31 March 2026)
• have certain long-term health conditions
• are pregnant
• live in a care home
• are the main carer for an older or disabled person, or receive a carer’s allowance
• live with someone who has a weakened immune system

Source: https://www.nhs.uk/vaccinations/flu-vaccine/

In Scotland, significantly wider free availability is in place

This includes:

• those aged 65 and over (on or before 31 March 2025)
• those aged 18 to 64 with an eligible health condition (as defined in the chapter 19 of the Green Book)
• those who are pregnant
• those living in a long-stay residential care home or other long-stay care facility
• those living with someone who has a weakened immune system
• an unpaid or young carer
• a frontline health or social care worker
• a non-frontline NHS worker
• a poultry worker or bird handler
• an asylum seeker living in a Home Office hotel or B&B accommodation
• those experiencing homelessness
• those experiencing substance misuse
• those living in a Scottish prison

Source: https://publichealthscotland.scot/population-health/health-protection/immunisation-vaccine-and-preventable-disease/seasonal-immunisations/flu-immunisations/adult-flu-immunisations/eligible-groups/

Second, uptake-levels in key groups are already significantly lower in key >65 group in England.

For 2024-2025, early trends show Scotland with stronger uptake among over-65s (71.6% vs. England’s ~60-65% estimated based on historical patterns) – multiple sources at: https://x.com/i/grok?conversation=1987603360061788291

Perhaps most indicative of the risk is the number of doses given and the contrast is shocking.

NHS Scotland has given 927 000 doses so far (down 20% on last year’s total): https://www.publichealthscotland.scot/publications/viral-respiratory-diseases-in-scotland-surveillance-report/viral-respiratory-diseases-in-scotland-surveillance-report-6-november-2025/

All things being equal, we might expect the figure in England to be around 9.27 million but it was only 4.3million: https://www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2025-to-2026-season/national-flu-and-covid-19-surveillance-report-6-november-2025-week-45

So, less than half the Scottish uptake per capita, in England, reflecting the wider free availability, above.

Has any journalist in Scotland noticed this?

NHS Scotland nearly 30% more beds, per head, than NHS England, to cope better with future pandemics

From Acute hospital activity and NHS beds information (annual) Year ending 31 March 2025 published today:

In 2024/25, the average number of available staffed beds per day for acute specialties was 13,717 – a 0.3% decrease on the previous year (2023/24) and a 3.7% increase compared to five years ago (2019/20). 

From NHS England’s Bed Availability and Occupancy Data (KH03 collection) for Quarter 4 2024/25 (January to March 2025), published on the NHS England statistics website:

106,068 is the total number of available general and acute beds (overnight) in NHS England for Quarter 4 of 2024/25 (January to March 2025), the most recent full quarter as of September 30, 2025.

All things being equal, per head, pro rata, NHS England might be expected to have around 10 times as many beds as NHS Scotland, 137 000, but had only 106 000, 31 000 fewer.

This NHS Scotland has, per head, 29.2% more beds than NHS England.

Might that have played a part in Scotland having a far lower Covid 19 pandemic death rate?

When adjusted for population (deaths per 100,000 people), the rates were closer: England (260 per 100,000), Wales (260), Scotland (190), and Northern Ireland (170). England and Wales had the highest rates overall. https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_the_United_Kingdom

Scotland has 71% more nurses

In England there were nearly seven nurses per 1,000 people, while there were nearly 12 per 1,000 in Scotland. https://www.dailyrecord.co.uk/news/politics/uk-fewer-nurses-per-head-33961132

OMG if the Daily Record doesn’t attempt to hide that, it must be true!

So, 5 more than 7 per 1 000 people, is 71.4%