The NHS was ill-prepared for Covid
The writer is Managing Director of the NHS Confederation, the membership body from all parts of the healthcare system in England, Wales and Northern Ireland
The UK has reached a dark and once almost unimaginable milestone: 150,000 people have now died within 28 days of their first positive test for Covid-19.
In March 2020, a senior health official said the UK would do well if it managed to keep the coronavirus death toll below 20,000. Although it turned out to be extremely optimistic, very few would have predicted that two years later we would face an almost eight times higher death toll – or that we would still be in the grip of the virus.
The public inquiry into the pandemic, which will begin this spring, will ask fundamental questions about the role of the state in responding to the crisis.
There will be important lessons to be learned. We owe it to these 150,000 people and the bereaved to address the fundamental failings that have meant that we entered the pandemic with 100,000 vacant NHS positions, dilapidated buildings, a lack of personal protective equipment and capacity. Limited diagnostic testing compared to other countries.
The government has allocated additional funds to the health and care system, some of which was raised through an increase in national insurance. The fact that we need to maintain an increase in real terms from year to year is not, as some suggest, a reflection of the failings of the NHS, but simply the reality of meeting the needs of an aging population. With digital and biomedical advancements, the long-term future of healthcare is bright, but boom and bust funding makes innovation and improvement more difficult.
Right now, the focus is on exiting the third wave of coronavirus. The Omicron variant seems to be smoother than the previous ones; Despite the huge increase in Covid infections, the proportion of those who have required hospital care has so far been lower. And those admitted tended to need less intensive care, such as mechanical ventilation.
This has been grabbed by some politicians and commentators who want to see the end of current Plan B measures and the country to “get over” the rest of the pandemic.
But there is no reason to be complacent. Covid hospital admissions have has exceeded 17,000 in the UK, and this rate doubles approximately every 12 days. This means we’re less than two weeks away from where we were at the peak of last January, when we had 38,000 hospital patients with Covid.
And for all the optimism surrounding this variant, there is no way of knowing exactly how Omicron will affect the public or the NHS. Our understanding of its behavior in different demographic groups, particularly among the elderly, is still limited.
The health service is battling on several fronts, including the rapidly increasing demand for emergency care, a huge backlog of operations such as hip and knee replacements, staff absences due to Covid and other diseases, and the need to implement the vaccine booster program at a sustained pace.
The main concern for NHS leaders right now is that a large number of their employees – sometimes more than one in 10 – are on sick leave or in self-isolation. Many hospitals have had to declare a critical incident due to these shortages. Despite their dedication, many NHS staff are exhausted after two years of battling Covid and its aftermath.
We urged ministers to mobilize more staff and other resources to bring the NHS through this extremely difficult time. Deployment of military personnel is welcome, but we need to ensure that health and care personnel have access to testing, consider the short-term use of clinical students in frontline tasks, and try to ensure that patients who do not need to be in the hospital can be discharged quickly. .
We are all hoping that Omicron marks the ‘end of the beginning’ of this pandemic and that we can find a way to live with Covid, but over the next few weeks the NHS will be under intense pressure. It will need support, but it must be supported.