Key points

• Coronavirus is putting the NHS under unprecedented strain at a time when demand for health and care services was already at an all-time high. Despite these challenges, trusts across the acute, community, mental health and ambulance sectors have achieved an extraordinary amount over the last few months.
• From expanding critical care capacity and the number of staff who can look after critically ill coronavirus patients and diverting planned care for patients, to placing services online, creating ‘mental health A&Es’ for patients in crisis and swiftly developing capacity to support rapid discharge of medically fit patients into the community, trust leaders are rightly proud of the significant transformation by the NHS to meet the demands the pandemic has placed upon it.
• Now that the NHS has successfully negotiated the initial peak of COVID-19 related demand, the NHS will need to strike the right balance between coping with COVID-19 related demand and meeting ‘ordinary’ healthcare demand.
• Trusts have worked hard throughout the pandemic to ensure that both those with, and without COVID-19, continue to receive the care they need. Trusts are acutely aware that ordinary healthcare demands have not simply vanished while the country is dealing with this virus.
• However, we need to be realistic both about what trusts can deliver and how quickly, acknowledging that re-starting services is going to be more complicated than stopping them and focusing on creating emergency capacity in crisis mode. It will not be possible for trusts to do everything at the speed we would all like: effective prioritisation will be key.