Thread by @ChrisCEOHopson

1/14 Important new blog for @timesredbox on why the NHS needs the Government and local authorities to now move quickly and decisively to create tougher local lockdowns wherever required:
thetimes.co.uk/article/hospit…

2/14 Increasing numbers of coronavirus cases have translated into rapidly rising hospital admissions, especially in NE, NW and Yorks. For a few trusts, the number of COVID-19 hospital patients is now at the same level they had reached at the height of the first phase.

3/14 Trust leaders clear about lessons from the first phase of COVID-19. The virus strikes at very different rates in different localities, so appropriate local responses are needed. The only way to control the spread of COVID-19 is by reducing social contact.

4/14 Two other crucial lessons from first phase. First, there is an inevitable lag between lockdowns being introduced, them taking full effect, and hospital admissions falling. Second, looser lockdowns have proved much less effective, as current infections rates show.

5/14 NHS challenge over the next few months is different from the first phase in three crucial respects. 1. Trusts must treat covid and non covid patients alike over the winter months when the NHS is at its busiest and NHS capacity is at its most stretched.

6/14 2. Every single hospital has lost between 10 and 30% of its capacity given the need to separate covid and non covid patients to keep them safe. 3. Frontline NHS staff are fatigued and in danger of burning out. To protect them, we must ensure a manageable winter workload.

7/14 NHS needs quick, decisive, consensual action on local lockdowns. Quick, because trusts in areas where virus is spreading rapidly can't wait any longer. Given lag in taking effect, lockdowns needed well before NHS capacity overwhelmed. If we wait longer it'll be too late.

8/14 Decisive, because lockdowns that rapidly and effectively cut covid transmission rates are now needed. It would be a mistake to introduce half hearted lockdown measures, only to have to tighten them later because they hadn’t been effective.

9/14 Consensual because local lockdowns need public consent and compliance to have the required impact. That needs clear messaging, the right financial support for impacted businesses and the endorsement of local politicians whose voice will be key in the areas affected....

10/14 …We must maximise the public consent for the tougher lockdowns that are now required. The most recent polling from Ipsos Mori suggests that 70% of the population are already behind the idea, so that is a very good start to building the required consent.

11/14 Trust leaders recognise difficult judgements to make here. No one can predict future. Everyone in NHS acutely aware of health risks from economic recession & long periods of enforced social isolation. NHS leaders can also see public frustration/fatigue with restrictions..

12/14 …Also a worry that, unlike the first phase, there is now a vociferous body of political and media opinion that opposes tougher lockdowns. And that this will make it more difficult for national and local leaders to take the tough, urgent, steps that are now needed.

13/14 But it’s the job of NHS trust leaders to protect communities they serve, provide treatment & save lives. Fight any public health threat with all resources at their command. Ensure they’re in the best possible position to treat all patients who will need help this winter.

14/14 That’s why, looking at the evidence and the risks, trust leaders are clear that quick, decisive, consensual local lockdowns are now needed. To manage the current challenges and avoid a more damaging national lockdown later.

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