NHS pressures: COVID-19 is just part of the picture

08 July 2021

NHS Providers says current pressures on the NHS mean that the predicted rising infection rates for COVID-19 will inevitably affect the speed at which trusts can recover care backlogs.

The organisation which speaks for every hospital, mental health, community and ambulance trust in the country, says that the full impact of the rising tide of COVID-19 infections on the NHS can only be assessed by looking at the complete picture of all current NHS demand and its current capacity constraints, not just the likely level of COVID-19 admissions.

Speaking ahead of the publication of monthly NHS performance figures, the chief executive of NHS Providers, Chris Hopson, said that although increasing COVID-19 infection rates will translate into much lower levels of hospital admissions compared to previous COVID-19 waves, this should not be seen as an indication that all will be well.

He emphasised the importance of seeing the overall pressures on the NHS rather than focusing solely on COVID-19:

"Trust leaders are worried that the public narrative is focusing on COVID-19 admissions in isolation rather than the full picture of the pressures their trusts are currently facing.

"To predict what the picture might look like in July to September this year, we need to look at four factors.

Trusts are working flat out to address the backlog of care which is bringing huge pressure on services and staff.

Chris Hopson    Chief Executive

"First, trusts are working flat out to address the backlog of care which is bringing huge pressure on services and staff. Second, demand is worryingly high for urgent and emergency care with a number of trusts reporting record levels of daily demand in June. On top of that the NHS is currently operating with significant capacity constraints because of continuing infection control measures.

"And finally, there is real pressure on staffing levels, given how many staff are having to self-isolate. This will get worse after restrictions ease on 19 July. Many staff are also due to take well earned annual leave, which is a priority. The impact of summer leave will be much higher this year given how much leave has been held over from earlier in the year and last year due to COVID-19 pressures.

"The challenge the NHS faces is the cumulative impact of all of the above.

So while COVID-19 admissions are likely to be much lower, the NHS is still likely, as a whole, to be under very significant pressure and this means something will have to give.

Chris Hopson    Chief Executive

"So while COVID-19 admissions are likely to be much lower, the NHS is still likely, as a whole, to be under very significant pressure and this means something will have to give. Most likely, in many places, this will be speed of care backlog recovery because trusts can control this much more easily than the demand for emergency or COVID-19 care."

On the question of ending COVID-19 restrictions he said:

"The government must continue to monitor the evidence between now and next Monday to ensure there are no significant changes to COVID-19 data that alter current calculations.

"Trust leaders can see the strong logic of 'if not now, when?' and they recognise that, as a nation, we must learn to live with COVID-19. But they want the government to be clear about the risks of relaxing restrictions. This includes the inevitability of higher hospitalisations and mortality, albeit at lower levels than previous waves and the risk of new and more dangerous variants emerging. They are also worried about the impact of long COVID.

"It's important these trade offs are clearly set out, including the impact on the NHS' ability to bear down on the backlog."

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