Trusts are committed to returning as quickly as possible to meeting the needs of all their patients and service users. However, it is evident from their responses to this survey that the task of restoring services which were paused as part of the early response to COVID-19 is complex.

Reconfiguring the NHS to respond to the pandemic was a monumental effort, and there is further complexity inherent in modelling demand, prioritising according to need, ensuring the workforce is available to provide services, managing the need for testing and isolation of patients as well as separating COVID-19 and non-COVID-19 patients, which makes restoring services a lengthy process.

Trusts have made clear that the ‘return to a new normal’ will not mean returning to the way the NHS operated before the COVID-19 pandemic. NHS providers and their staff have already undertaken rapid innovation, often working together and with other local partners in systems to prepare for COVID-19 and continue to provide non-COVID care in the most urgent cases. Trusts are not looking to return to the old ways of working where helpful recent innovations could be embedded. But there are challenges which must be addressed, including around capacity, changes in the volume and profile of demand, and uncertainty surrounding the future behaviour of the virus and the potential for further outbreaks.

This means trusts need sustained realism from government and the national bodies about how they will return to full operation, and over what timeframe. While the public should have full confidence that the NHS is there to treat and care for them when they need it, we also need a much more open conversation about the differences we will all see in how that care is delivered for some time to come.