Health and Social Care select committee submission: Delivering Core NHS and Care Services during the Pandemic and Beyond

Our written evidence looks at how the NHS will balance re-starting core NHS and care services whilst also maintaining enough capacity to treat COVID-19 patients. 

Key messages

• The NHS has worked at speed to transform services in the face of COVID-19, providing care for those suffering from the virus by scaling up capacity, as well as continuing to care for patients with other conditions. However, this has inevitably impacted on core services, which have had to be de-prioritised in the short term to ensure capacity for COVID-19. NHS trusts have done all they can to manage this impact, particularly prioritising the most clinically urgent patients.

• Trusts will need to be prepared for further waves of COVID-19, and it will be necessary to retain ‘surge’ capacity in order to address possible future demand.

• However, retaining surge capacity and the staffing required to support this, will clearly have an impact on the NHS’s ability to manage ‘ordinary’ demand. Trusts are keenly aware of their responsibilities to restart ‘ordinary’ business but managing day-to-day demand alongside a stream of COVID-19 patients, and maintaining surge capacity, will be complex, difficult and challenging, and will require effective prioritisation.

• We welcome recent correspondence from NHS England and Improvement (NHSEI) on moving towards the second phase of the NHS’ response to the pandemic, which outlines some clear national prioritisation, while allowing considerable local flexibility for trusts to make decisions around which services they are able to resume safely and when.

• However, it is vital to ensure providers maintain the flexibility to make decisions which work for their local trust and their patients. The pandemic has affected different areas of the country in different ways, at different times: a one size fits all approach will not be suitable when it comes to resuming services. • Community service providers and mental health providers have played a key role throughout the pandemic, harnessing innovation to deliver for patients in their own sectors, as well as freeing up space for critically ill patients. However, we need to be aware of the pressure facing these services, particularly given the pent-up demand that the NHS is going to face when services resume. Whilst the initial wave of demand has lessened in acute hospitals, capacity is hugely stretched in community services and mental health providers are already beginning to report a significant increase in demand.

• Testing is key to managing the spread of the virus, avoiding further spikes in cases and resuming core services. The Government needs to urgently update its 4 April testing plan so trusts can be clear what is required of them. While the situation is improving, the flow of Personal Protection Equipment (PPE) to trusts is still not as consistent and reliable as it needs to be.

• It will be vital to ensure the NHS is sufficiently prepared to manage pandemic related demand alongside the flu season and typical winter pressures.

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