A new briefing by NHS Providers says the health service is on course to successfully navigate the initial peak in coronavirus cases.

Confronting coronavirus: the story so far presents a detailed account of the preparations to deal with the pandemic, and insights on how the NHS is coping with the greatest challenge in its history.

The briefing, which is peppered with powerful anecdotes from the frontline, also addresses continuing difficulties on issues such as personal protective equipment (PPE) and testing, and warns of the potentially damaging lasting impact of the pandemic for NHS patients and staff.

It describes in vivid terms the extraordinary efforts to expand NHS capacity as the threat of the virus became a reality – equivalent to building more than 50 district general hospitals in less than a month – including steps to accelerate discharges of medically fit patients, relocate care, install oxygen supplies and retrain staff.

It describes in vivid terms the extraordinary efforts to expand NHS capacity as the threat of the virus became a reality – equivalent to building more than 50 district general hospitals in less than a month – including steps to accelerate discharges of medically fit patients, relocate care, install oxygen supplies and retrain staff.

   

tweet this

The briefing also highlights the crucial contribution of mental health, community and ambulance trusts in expanding and adapting their services as part of a collective effort encompassing the entire NHS workforce, and it highlights the advantages of having a nationally coordinated health service rather than a fragmented system where hospitals may be left to "sink or swim". It also acknowledges the crucial role being played by primary care, social care and voluntary organisations like hospices.

The document identifies four key factors in the NHS being able to successfully respond to the current surge in cases:

• extensive planning and preparation carried out by the NHS since 30 January
• additional capacity created, in terms of space, beds, staff and equipment
• the impact of social distancing in slowing infection
• the extraordinary response of frontline staff.

The key difficulties encountered in responding to the virus are confronted head-on, including the problems of securing reliable supplies of PPE equipment, especially gowns, and developing a distribution system at pace to meet massively increased demand at the 217 NHS trusts and foundation trusts, and thousands more sites including hospices, care homes and GP practices. The briefing acknowledges the huge effort to supply PPE to the frontline, but also argues that gaps remain and it would help if these were acknowledged.

On testing, trust leaders were clear early on that they wanted to test significant numbers of staff. The briefing sets out why testing capacity was constrained and the impact this had on an already overstretched workforce, particularly in light of what trust leaders saw as a gap between government statements on testing and the underlying reality and detail.

Other concerns addressed include the risk of "over-prioritising" COVID-19 at the expense of the treatment of other critical conditions such as cancer, the potential harm involved with accelerated patient discharge and the sharp decline in A & E attendances indicating that some patients who need help are not seeking it. It also recognises the burden that rapid discharge from hospital has placed on already stretched community and social care services.

Looking beyond the initial peak in cases, the briefing highlights the importance of continuing to protect the NHS as we move towards an "exit strategy" for the lockdown. A key priority will be to avoid a spike of coronavirus cases coinciding with the traditional NHS winter peak, creating a perfect storm of demand. It also suggests that the biggest challenge facing the NHS beyond this initial peak is the need to support staff to work longer, at a high level of pressure and intensity, than was initially expected.

A key priority will be to avoid a spike of coronavirus cases coinciding with the traditional NHS winter peak, creating a perfect storm of demand.

The briefing also highlights the likely significant increase in demand for mental health services given the economic impact of coronavirus including the need to come to terms with loss of life and psychological impact of a prolonged period of social distancing and lockdown. It says the NHS must rapidly prepare to deal with completely new requirements such as providing care to groups of highly vulnerable patients who will need shielding for many months; the need for comprehensive mass national testing and vaccination campaigns and how to meet the pent up demand from those who are not currently accessing NHS services but probably need to.

The chief executive of NHS Providers, Chris Hopson, said:

"The NHS is facing the challenge of its lifetime. The response has in many ways exemplified all that is best about our health service, including the commitment and compassion of frontline staff, the resolve and resourcefulness of trust leaders, and the overwhelming generosity and support of the British public.

The NHS is facing the challenge of its lifetime. The response has in many ways exemplified all that is best about our health service, including the commitment and compassion of frontline staff, the resolve and resourcefulness of trust leaders, and the overwhelming generosity and support of the British public.

tweet this

The pandemic is a tragedy for so many people who have lost loved ones. But we know there are thousands more who have survived thanks to the brilliant care they have been given by the NHS.

We are approaching a crucial moment as indications increase that the first surge is starting to level off. We can not relax. We must remain vigilant. We must continue to protect the NHS."