Restoring services: The NHS is rising to the challenge once again
10 September 2020
Growing evidence is emerging of the extraordinary commitment and innovation of NHS frontline staff to restore services for non COVID-19 patients.
NHS Providers will highlight examples of this outstanding work, covering a wide range of activities and procedures, in a new series of briefings over the coming months.
Restoring services: NHS activity tracker will set out in detail how trusts and staff are working to raise levels of routine care despite the continuing threat from COVID-19, and the need to prepare for additional winter pressures.
Trust leaders are only too aware of the disruption and distress for many patients caused by the need to focus on COVID-19 at the height of the pandemic. However, recent claims that all non-COVID care coming to a grinding halt are simply not true. At the peak of the pandemic, for every one COVID-19 patient in hospital there were two non-COVID patients being treated for other conditions. And most mental health and ambulance, and many community services, continued to function at their pre-COVID levels of activity, or higher.
Trusts and frontline staff are now working flat out to restore those services which were necessarily interrupted to cope with COVID-19. They are doing so in the context of a range of COVID-19 related constraints that, for some trusts, have meant the loss of between 10% and 30% of their normal capacity.
These constraints include:
- Loss of waiting room and/or bed capacity due to social distancing in acute, mental health and community settings
- Loss of surgical and patient facing time in all settings due to the need to wear and change, with appropriate frequency, cumbersome personal protective equipment
- Loss of access to diagnostic testing equipment and other physical equipment due to the need for deeper and more frequent cleaning between patient treatments
- Loss of bed space and access levels to diagnostic equipment due to the division of estates into COVID and non COVID areas
- Limitations on ambulance trust capacity due to the need for deep cleaning vehicles.
By offering frontline commentary and compelling case studies, this new series will show the spirit of resilience and resourcefulness that served the NHS so well at the height of the pandemic is alive and well as trusts rapidly recover service volumes.
Examples from the first briefing include:
- Restoring cancer screening and treatment services at Addenbrookes Hospital in Cambridge by compressing treatment times when it was safe to do so, extending opening hours and staff working weekends
- A new drive-through lung function testing system at Luton and Dunstable Hospital Foundation Trust
- Increasing virtual outpatient appointments, expanding waiting room capacity and using private sector capacity for planned care in Epsom and St Helier University Hospitals
- Finding new ways to maintain mental health services during the pandemic and working with service users to co-create a service in East London
- Exceeding pre-COVID heart and lung transplant service activity and restoring cardiology services at Royal Papworth Hospital NHS Foundation Trust.
The chief executive of NHS Providers, Chris Hopson, said:
"Much of the public commentary over the last few months has focused on how far NHS activity has fallen. Very little of it has focused on how hard NHS frontline staff are working to recover services and how rapidly they are succeeding.
"Every trust leader recognises that COVID-19 has forced the delay of some treatments to patients and that this has significant impact for patients and their families. No-one underestimates the huge challenge this poses for the NHS.
"But we also owe it to frontline NHS staff to recognise their hard work, their ingenuity and their persistence in overcoming a set of wicked constraints – lost beds, lost patient and surgical time, lost diagnostic test slots – because of the unavoidable need to protect patients from COVID-19.
Frontline staff are working just as hard, and being just as innovative, as they were in the first COVID-19 peak earlier this year.Chief Executive
"As our new briefing shows, frontline staff are working just as hard, and being just as innovative, as they were in the first COVID-19 peak earlier this year. Chief executives tell us that they are recovering activity levels significantly faster than they were expecting to, just two or three months ago.
"Trust leaders worry that the current unrelenting focus on what the NHS is unable to do, as opposed to how rapidly it is recovering services, is also discouraging patients from coming forward to seek help when they need it.
"The NHS is there for all patients, whatever their need. Trusts are going as fast as they can to treat the same number of patients as they were before the pandemic hit, despite the constraints they face. Our new project will shine a light on some of the incredible things trusts are doing up and down the country to make this happen."