COVID SURGE AND THE IMPACT ON THE NHS
As the surge in COVID cases continues, we are seeing an impact on the ability of the NHS to maintain normal services. At the end of July, Simon Stevens laid out the next phase of the response to COVID, which included the return to near-normal levels of non-COVID health services. This remains current central policy.
The third phase letter was however written at a time when, COVID inpatient numbers had fallen nationally from a peak of 19,000 a day, to around 900. As of the end of October, inpatient numbers are around 7,000, about a third of the level we were at during the peak, with estimates that if the rate of growth continues as it is, it means that in a month's time we will be above that peak level. The number of COVID patients treated in hospital in Liverpool has already surpassed the peak of the first wave.
We are therefore concerned that we will see a growth, once again, in hospitals cancelling non-urgent interventions. In Tier 3 areas we are already seeing some hospitals cancelling non-elective work (see the ABHI Trust Tracker) and organisations including the BMA, are warning that mass cancellations of routine operations in England are inevitable this autumn and winter.
Of course much of this is prediction, albeit based on sound modelling and precedent, but if the restrictions being introduced locally reduce cases, then hospital admissions could be contained.
We continue to engage with Ministers and the NHS on this critical issue and our messages are strong and consistent:
- Ensuring that the capacity to deliver planned care is maximised by measures such as the designation of some hospitals as “COVID light,” elective only centres, the continuation of funding to use independent sector capacity as necessary and use of Nightingale Hospitals to supplement NHS capacity.
- Running a public information campaign to reassure citizens that it is safe to engage with the health system.
- Expediting the move to integrated care working, especially with regards to initiatives such as shared waiting lists and flexibility in payment mechanisms.
It should however be noted that, at present, most hospitals are continuing with non-urgent care and we are engaging closely with Members and the system on access issues. Our advice on virtual first remains and most hospitals are still limiting access to appointment-only, based on clinical need. Several Trusts have established policies requiring asymptomatic testing of HealthTech industry staff, which we have challenged, and have published an update on the situation.