NHS Providers says the national lockdown should end as planned next month only if it's clear the NHS can cope with the pressures of the pandemic.

The membership organisation for every NHS hospital, community, mental health and ambulance trust in England says even if national restrictions are eased, local measures will need to be "appropriately tough" to minimise social contact in the run up to Christmas.

It says the last few months have shown the rules in the old first and second tiers were insufficient, and that we will need a stronger regime than the old third tier in areas of greatest spread. Those tougher restrictions will need to be adopted quickly and automatically wherever they are needed, rather than becoming a focus of debate between national and national leaders.

NHS Providers' chief executive, Chris Hopson, underlines the importance of getting through the "hump of winter" from late December to March, when the NHS is at its busiest.

   

A blog by NHS Providers' chief executive, Chris Hopson, underlines the importance of getting through the "hump of winter" from late December to March, when the NHS is at its busiest, and the importance of maintaining services for three groups of patients: those with the virus, emergency patients and those who need planned care. He highlights lost bed capacity due to enhanced infection control measures, and the impact of sickness absence rates among staff.

Yet trust leaders are warning that with demand for emergency care rising rapidly, it feels like we've hit winter six weeks early. This is reflected by:

• Rising numbers of twelve hour waits in hospital emergency departments
• Higher levels of the sickest patients than usual
• Ambulance trusts reporting significant handover delays
• Delays in discharging patients who are medically fit to leave hospital

Chris Hopson predicts that by 2 December although infection rates will be coming down and the rate of increase in hospital admissions will have slowed we still won't be on top of the virus, but will instead be caught in a "COVID halfway house".

He warns of a real risk that in our desire to celebrate as we head towards Christmas we risk the misery of a full third wave of COVID-19 a few weeks later. Emphasising the need for clarity as we approach the end of this lockdown period, he calls for "one more heave" to continue tough restrictions, with the reflection that if we can surmount the hump of this winter there is reason to believe that next spring and summer we will be free.