Many trusts now facing dramatic loss of capacity

NHS Providers has highlighted the scale of the challenge ahead as the NHS recovers from the first peak of the virus, with many facing increased demand and the dramatic loss of capacity.

The organisation’s report, Recovery position: What next for the NHS?, sets out the scale of increased demand and the dramatic loss of capacity many trusts are now facing as the NHS juggles treating coronavirus patients with restarting the full range of services. The report shows that, whilst trusts are restoring services as fast as they can, some trusts, particularly acute hospitals, believe this restoration will take more than six months.

Based on a survey of 158 trust chairs and chief executives, and commissioned by the House of Commons Health and Social Care Select Committee, NHS Providers finds that 54 per cent of trust leaders report increased demand for more urgent or crisis care and/or severe and late presentations/contacts from patients, with 89 per cent believing that there is now an increased backlog of people waiting for care.

Additionally, the report shows that 92 per cent of leaders believe physical and social distancing, required for effective infection control, reduces available capacity. This is on top of statistics which show that 92 per cent are concerned about staff well-being, stress and burnout following the pandemic, 80 per cent believe there is an unpredictable level of coronavirus demand, 57 per cent believe there is insufficient testing capacity and 53 per cent believe there is insufficient PPE supply to fully restart services.

Trusts are doing all they can to restart services as quickly as possible. In fact, 86 per cent of trusts have increased capacity for remote services like video consultations, while 78 per cent have reconfigured their workforce to speed up the resumption of services. However, the combination of significantly increased demand and significantly reduced capacity means services will take significant time to resume, particularly in acute hospitals.

Chris Hopson, chief executive of NHS Providers, said: "Trusts have achieved a great deal over the past four months. They expanded critical care capacity, accelerated the safe discharge of patients, moved thousands of outpatient appointments online and created mental health A&Es to support those in crisis. They also kept critical services going. But, to avoid overwhelm in the first Covid-19 peak, the NHS had to suspend some services. The challenge is to now restart those services. Trust leaders are deeply aware of their responsibility to do this as quickly and safely as possible.

"This report clearly shows that the NHS faces a really difficult problem. Some trusts will be losing as much as 40 per cent of their capacity for as long as Covid-19 is with us. There are also many more patients to now treat. Trust leaders are as frustrated as patients and service users that they can’t go faster. But it’s not just a case of flicking the light switch back on. Covid-19 brings a whole new set of demands and the overwhelming priority must be to provide safe care. Our survey shows that the NHS will simply not be able to do all that is currently required of it. We must have an honest and difficult debate about priorities.

"Berating trusts for not going faster won’t help. Trust leaders and frontline staff will bring the same commitment, pace and problem-solving ingenuity to this task that they demonstrated when creating 33,000 beds in less than a month to treat Covid-19 patients in the first peak. The government must also recognise that the NHS needs more capacity to offset what has been lost as a result of Covid-19. There is now a key decision to make on whether to keep independent sector beds and the Nightingale hospitals and to fund the extra capacity needed in community, mental health, general and acute beds and emergency departments. Without that capacity the NHS task would simply be impossible."

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