We write to you as the membership organisation for England’s NHS hospital, ambulance, community, and mental health trusts, with all 216 trusts in membership.
Today you will vote on regulations to introduce a new nationwide lockdown. We know there is a difficult choice between a lockdown and the impact of renewed restrictions on people’s liberties, livelihoods, their mental health and importantly, on the wider economy. However, the trust leaders we represent are asking you to vote in favour of the regulations.
The task the NHS faces this winter - dealing with a second COVID-19 surge, coping with winter pressures, and recovering important care backlogs from the first phase of COVID-19 - already looked very difficult. Added to this, keeping COVID and non-COVID patients safe and separate has reduced NHS capacity by 10 to 30%, depending on the trust concerned. Staff are in real danger of burning out and trusts in areas with higher rates of COVID-19 tell us they are, understandably, seeing significant increases in sickness absence.
Even at the best of times, winter is challenging for the NHS. The number of patients needing treatment can quickly outstrip capacity, leading to a greater risk of poor quality care, despite the best efforts of frontline staff. If the NHS has too many COVID-19 patients, we won’t be able to treat winter emergency patients in the way those patients need, and we will have to reduce the speed at which we recover the backlog of care that built up during the first wave of the pandemic.
That’s why NHS trust leaders have argued that controlling the spread of COVID-19 – the most controllable of these elements – is vital.
That’s why NHS trust leaders have argued that controlling the spread of COVID-19 – the most controllable of these elements – is vital. But the combination of a tiered approach to local lockdowns and test, trace and isolate has failed to curb the growth in COVID-19 cases. We have lost control.
Last week, the NHS saw nearly 2,800 new COVID-19 patients admitted into hospital, the equivalent of five whole hospitals full of new COVID patients in just seven days. Daily admissions are now higher than on 23 March, the date of the first lockdown. Hospitals from Stoke, Leeds and Liverpool to Greater Manchester, Nottingham and Blackpool are now seeing a higher number of patients with COVID-19 than they did in the peak of the first wave of the virus.
The levels of NHS hospital admissions and inpatients are, depending on area, between two and four times higher than the reasonable worst-case scenario the NHS was asked by government to plan against. Despite doing everything they can to avoid this, the hospitals under the greatest pressure are now being forced to start cutting back on routine surgery.
Looking forward, there is a clear and present danger that the NHS will not be able to treat all the patients it needs to in the best and most timely way.
Looking forward, there is a clear and present danger that the NHS will not be able to treat all the patients it needs to in the best and most timely way. Last week’s government projections, developed by SAGE, showed a big increase in potential COVID-19 hospitalisations. They suggested that all spare hospital beds would eventually be used up - quickly in some parts of the country - including full use of the backup Nightingale hospital capacity.
Trust leaders yet to experience a full second COVID-19 surge are deeply worried that, on current trends, the surge their trusts will experience will coincide with the onset of winter when they are at their most stretched.
Urgent action is needed.
Trust leaders are clear that they cannot ask hardworking NHS staff, many of whom are already exhausted, to care for your constituents without doing everything they possibly can to support them.
Trust leaders are clear that they cannot ask hardworking NHS staff, many of whom are already exhausted, to care for your constituents without doing everything they possibly can to support them. The logic is simple: too many COVID-19 patients will jeopardise the health service’s ability to provide the care to all patients who need it and give frontline NHS staff an impossible task this winter. No one wants that.
However much we would have liked alternatives to work, trusts are clear that moving to a national lockdown is the only realistic option now available if the NHS is to look after patients in the way it needs to. As currently constituted, the lockdown will also enable greater economic support for those most affected. This will help manage the demand for wider NHS services - including mental health care - which is also rising exponentially.
Maximising public compliance and support for the new lockdown is vital if we are to ensure the NHS has the capacity it needs this winter. Trust leaders are worried that the larger the vote against the regulations, the more that public compliance and support will be at risk. We are therefore asking you to vote in favour of these regulations.
This was first published in The Times Redbox.