Thread by @ChrisCEOHopson

We need to give proportionate focus to daily London hospital admissions data. The data is important as it should give the earliest clinical evidence, and a good sense, of likely severity of omicron and hospitalisation/mortality rates for the specific UK context...1/10

But we also need to take a much broader view of NHS pressure. All demand - non covid as well as covid care. Level of staff supply, including level of staff absences. And recognise that the NHS isn't just about hospitals - health and care is an interconnected system...2/10

So pressures in community services, mental health, primary care, social care and ambulances can be just as serious/harmful for patients as pressures in hospitals. And those pressures will also then show in hospitals, e.g. pressures on discharge and extra A&E demand....3/10

It's far too simplistic to just look at covid hospitalisations and say "they're not that high [e.g. compared to previous peaks] and the NHS should therefore be able to cope". The question is what quality of care is all of the NHS able to provide to all who need it?...4/10

It's very striking how many trust chief executives are saying that they think workforce pressures are the fundamental challenge. Trusts are currently facing a very difficult combination of staff absences, vacancies and difficulties sourcing agency / bank shifts...5/10

Important to remember that the NHS is coping with three major challenges at once. Very high levels of non covid demand e.g. urgent care and planned care backlogs. Massively extending booster vaccination campaign at pace. Preparing for omicron surge should it arrive...6/10

Any one of these is a big challenge. All three at once means the NHS is currently beyond full stretch. But, as shown over last 18 months, thanks to the professionalism and commitment of frontline staff, NHS is remarkably resilient and keeps meeting extraordinary challenges...7/10

So, even if the omicron hospital covid caseload is lower than some of the worst case, or even mid range, predictions, we need to recognise and acknowledge how pressured the NHS will still be. And how hard we will still be having to ask our frontline NHS staff to work….8/10

We are not calling for tighter restrictions on social contact at this point as the data on omicron severity remains inconclusive. Government should, however, be getting ready to move very fast should the evidence show that further restrictions are necessary....9/10

Some really important underlying issues to address here. Including massive ongoing mismatch between demand & capacity. And the need for rigorous long term workforce planning. These are key to ensuring frontline NHS staff have a reasonable workload on a sustainable basis. 10/10