Observations of SARS-CoV-2 variant of concern B.1.1.7 at the UK's largest hospital trust

•SARS-CoV-2 variant of concern B.1.1.7, with increased transmissibility, was identified in the UK in October 2020.•We report our observations of B.1.1.7 in patients admitted to University Hospitals Birmingham NHS Foundation Trust (UHB), one of the largest tertiary referral centres in the UK.•B1.1.7 was observed to affect patients of younger age, led to increased admission to critical care with longer stay but the association wasn't statistically significant.•Significantly more patients presented with a cough (odds ratio of 2.19; p = 0.0443) Increased coughing could be associated with increased transmissibility and nosocomial infections.•Importantly, UHB have seen more outbreaks within the acute setting in January 2021 when the new variant became the dominant strain.•Real time whole genome sequencing will be useful to rapidly identify new variants within the hospital setting to facilitate appropriate patient management.