Winter Watch: The Impact

In our final episode for our NHS Winter Watch series we talk to our in-house analysis experts, Claire Helm and Julian Russell, as we decipher the impact that COVID-19 has had on the NHS over the winter months. We discuss the scale of comparison from previous winters, review critical care, and reflect on the great work of trusts leading us into the future.



This year the NHS has adapted, innovated and managed like never before

NHS Providers senior media and communications officer Nicole Hardy looks back at the winter period for this year, as well as across contributions to our Winter Watch campaign.

In March each year we reflect on the winter period in the NHS – traditionally a highly challenging period for trusts. Last winter we looked back on dedicated winter funds, and the general election where there were promises of capital investment and social care reform, alongside pledges to boost workforce numbers. The government had just put out its first action plan for the health and care system to deal with coronavirus and to keep people safe. The NHS is in a very different position this March.

At NHS Providers, we spent the past 13 weeks tracking, analysing, and commenting on the weekly winter sit-rep data, published by NHS England and NHS Improvement, in our NHS Winter watch campaign. We adapted our approach this year, releasing podcasts and short videos, alongside blogs, showcasing real work and examples beyond the figures. We tracked the innovations and plans trusts and stakeholders put in place to help address COVID-19 pressures, including initiatives to support tired and overstretched staff facing burnout. Our analysis team guided us through the performance figures in our regular podcasts, and we published tweet threads diving deep into the data.

This year COVID-19 took front and central stage. In November, the North East and Yorkshire region had the second highest number of COVID-19 hospital admissions in the country. Stephanie Riddington from Newcastle upon Tyne outlined a new and innovative way of treating both COVID-19 and non-COVID patients in intensive care settings. She discussed the refurbishment of a ward, which became a new 17 bedded intensive care ward at Newcastle's Royal Victoria Infirmary, thanks to the dedication of the estates team and clinical leaders. Meanwhile, Northumbria Healthcare's Jim Mackey discussed the procurement of personal protective equipment.

Digital innovation was a key theme this year. North East Ambulance Service chief executive Helen Ray discussed a refined urgent emergency care app that communicates real time information to colleagues to better understand flow across the entire emergency care system, highlighting pinch points in pressures. Dr Ayesha Rahim, consultant perinatal psychiatrist and chief clinical information officer for Lancashire and South Cumbria, outlined the technology they are using to reduce pressure on secondary healthcare and enable access to mental health services at the first point of care.

It is clear that staff wellbeing needs are increasing as the pandemic continues. Many staff are suffering fatigue, morale is low and they are at risk of burnout.

Dr Esther Cohen-Tovee    director of AHPs and psychological services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Throughout the campaign this year, we heard from many trusts showcasing how they are supporting their staff who are working tirelessly to treat COVID and non COVID patients and rolling out the vaccination campaign. Cumbria, Northumberland, Tyne and Wear's Dr Esther Cohen-Tovee described a new COVID-19 emotional wellbeing team set up during the first lockdown, and how it continues to be a vital resource for staff. She described advice newsletters they send to staff, livecasts, wobble rooms, as well as formal psychological helplines. Professor Neil Greenberg, a consultant occupational and forensic psychiatrist from King's College London, discussed the damaging impact the pandemic has had on healthcare workers' mental health and wellbeing, and the important steps healthcare leaders will need to take to protect staff in the coming months. Simon Barton, chief operating officer at Sherwood Forest, reflected on this winter, in terms of the challenges faced by staff and how they are being supported. He also highlighted the extra measures taken by the trust to manage the rise in demand such as expanding critical care capacity by 300%, reconfiguring admissions pathways and working collaboratively.

We have put a package of measures put in place to support colleagues, but there are some things that we just can't fix. We can't fix the loss that people saw every day, we can’t take away their trauma, and we can't fix the fact that we have been living and working with this virus for a year.

Simon Barton    chief operating officer, Sherwood Forest Hospitals NHS Foundation Trust

We also heard from stakeholder organisations, such as St John Ambulance, who exemplified the positive impact that partner organisations can have when they join forces with the NHS. Craig Harman, ambulance and community response director, focused on how the charity is supporting the administration of coronavirus jabs, and also how volunteers boost staff resource. Locum's Nest co-founder Dr Ahmed Shahrabani wrote about the success of the new "vaccination hub" on their platform, and the support they have provided to North Middlesex University Hospital NHS Trust. As a member of the Digital Collaborative Bank, the trust can directly plug their workforce gaps from nine large acute NHS trusts across all grades and specialties.

As for most organisations on the planet, but especially those in healthcare, the COVID-19 pandemic has thrown up challenges like no others. On the basis of our strong and longstanding relationship, the NHS called on us to assist and we were standing ready to step up.

Craig Harman    ambulance and community response director, St John Ambulance

Separately, Care Quality Commission talked to us about winter inspections, and issues within infection prevention and control, as well as the launch of their tool Patient FIRST which helps frontline clinicians. Meanwhile Amanda Pritchard, NHS England and NHS Improvement’s chief operating officer, reflected on the past year, the legacy of the pandemic and gave her own personal message of thanks to health and care workers.

What I took away from the campaign this year was that while the NHS was under unprecedented pressure, and operating with constrained capacity, it continued to do what it does best – it adapted, innovated and managed – doing all it could to deliver for patients. Staff, no matter their role, re-thought their entire approach so that they could come together as a force to look after those who needed them. There has been so much progress, but there is still a long way to go. While I am not certain on how long the pandemic will impact the health service in the years to come, what I do know is that staff will keep doing all they can – as they have done this winter and before – to help keep us safe and well.