1/17 Where are we up to? The NHS trust perspective on the current COVID-19 second surge and the imminent national lockdown set out below in one of my threads. Usual statement at the top - @NHSProviders is the voice of NHS trusts. We are not the Government or @NHSEngland.
2/17 NHS trust leaders have been saying for a very long time that the task they faced this winter already looked very difficult. Clear risk of a “perfect storm”: full blown second covid surge, usual winter pressures as well as recovering important care backlogs from first phase…
3/17 …At a point when NHS capacity has been reduced (hospital trusts saying by between 10-30%) due to need to keep covid and non-covid patients separate. And when staff are tired, with risk of sickness absence rising in any covid second surge. All on top of 80,000 vacancies.
4/17 We must also remember how difficult winter (late Dec – March) can be for NHS, at the best of times. The number of patients needing treatment can outstrip capacity in some areas, leading to greater risk of unsafe and poor quality care, despite best efforts of frontline staff.
5/17 That’s why NHS trusts have been arguing that controlling spread of COVID-19 – the most controllable of these elements – is vital. If NHS has too many COVID-19 patients, it risks not being able to treat winter emergency patients and it will have to stop recovering backlogs.
6/17 But it’s now clear that current Government strategy to control spread – the tiered approach to local lockdowns and test and trace - is not working effectively enough. And the virus is now spreading rapidly from the North West and Yorkshire to other parts of the country.
7/17 It’s almost as if, in our desperation to return to normal life, we've forgotten inexorable basic logic here. The greater the level of social contact, the greater the level of virus spread. Schools, universities, shops, pubs & restaurants all open at same time= more spread.
8/17 Over the last seven days, the NHS has seen nearly 2,800 new covid patients admitted into hospital. That’s the equivalent of five whole hospitals full of new covid patients. In just a week. Daily admissions are now higher than on 23rd March, the date of the first lockdown.
9/17 Hospitals from Stoke, Leeds and Liverpool to Greater Manchester, Nottingham and Blackpool are now seeing a higher number of patients with covid-19 than they did in the peak of the first wave of the virus. Admissions are beginning to rise across the rest of the country.
10/17 The levels of NHS hospital admissions and inpatients that we are now seeing are, depending on area, between 2 and 4 times worse than the reasonable worst case scenario the NHS was asked by Government to plan against. Put simply, we have lost control of the virus spread.
11/17 Looking forward, there's a clear risk that the NHS will not be able to treat the patients it needs to. It's important to note that the new internal Government projections last week showing a big increase in potential covid hospitalisations came from SPI-M/SAGE, not the NHS.
12/17 Those projections suggested that all spare hospital beds would eventually be used up, pretty quickly in some parts of the country. This included full use of the "back up, insurance policy" Nightingale hospital capacity. Clear that a new policy approach was needed, quickly.
13/17 This is not a massive surprise if you look at what is happening in Europe. These are very similar trends to what hospitals in France, Germany, Belgium and the Netherlands are also facing. Hence the French and German lockdowns announced in the past week or so.
14/17 Everyone in NHS recognises that moving to tighter restrictions has serious health and economic implications. None of us, NHS trust leaders included, would want to be here. But there is no realistic alternative to a much tighter set of restrictions, given where we now are.
15/17 The key, having decided on tougher restrictions, is to ensure maximum compliance with whatever is announced. That requires clear, effective, communication from the Government and public trust in its approach. Yesterday’s rushed, leak forced, announcement not ideal.
16/17 Trust leaders seriously worried that the siren “anti-lockdown” political, epidemiological and media voices which have been so evident over the last few months risk reducing compliance. Important for all of us making public comment to help ensure maximum compliance.
17/17 Two key messages for general public. The NHS is there for you, if you need treatment. Please come forward if you need help. We will treat you, safely. But please, also follow any new rules, however difficult they seem, so we can carry on helping all of you over winter.
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