January 17, 2022

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The NHS was left ill-prepared for Covid

The writer is chief executive of the NHS Confederation, the membership body for all parts of the healthcare system in England, Wales and Northern Ireland

The UK has reached a grim and once almost unimaginable milestone: 150,000 people have now died within 28 days of their first positive test for Covid-19.

Back 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 people. While that turned out to be wildly optimistic, very few would have predicted that two years on we would be facing a death toll of almost eight times that number — nor that we would still be in the grip of the virus.

The public inquiry into the pandemic, to begin work this spring, will pose fundamental questions into the role of the state in responding to the crisis.

There will be significant lessons to learn. We owe it to those 150,000 people, and the bereaved, to address the fundamental failings that meant we entered the pandemic with 100,000 staff vacancies in the NHS, rundown buildings, a lack of personal protective equipment and limited diagnostic testing capacity compared with other countries.

The government has allocated extra funding to the health and care system, some of it raised through a rise in national insurance. The fact that we will need to sustain a real-terms increase year on year into the future is not, as some suggest, a reflection of the failings of the NHS but simply the reality of meeting the needs of an ageing population. With digital and biomedical advances, the long-term future for healthcare is bright, but boom and bust funding makes innovation and improvement harder.

Right now the focus is on getting through the third wave of coronavirus. The Omicron variant appears to be milder than previous ones; despite the huge rise in Covid infections, the proportion of those who have needed hospital care has so far been lower. And those admitted have tended to need less intensive care, such as mechanical ventilation.

This has been seized on by some politicians and commentators who want to see an end to the current Plan B measures and for the country to “ride out” the remainder of the pandemic.

But there are no grounds for complacency. Hospital admissions from Covid have topped 17,000 in the UK, and this rate is doubling roughly every 12 days. This means we are less than two weeks short of where we were at last January’s peak, when we had 38,000 patients in hospital with Covid.

And for all the optimism around this variant, there is no way to know exactly how Omicron will affect the population or the NHS. Our understanding of its behaviour in different demographic groups, particularly in older people, is still limited.

The health service is fighting on multiple fronts, not least from rapidly rising demand for emergency care, a huge backlog for operations such as hip and knee replacements, crippling staff absences due to Covid and other sickness, and the need to deliver the vaccine booster programme at significant pace.

The number one concern for NHS leaders right now is that huge numbers of their staff — sometimes more than one in 10 — are on sick leave or self-isolating. Multiple hospitals have had to declare a critical incident because of these shortages. Despite their dedication, many NHS staff are exhausted after two years of wrestling with Covid and its consequences.

We have urged ministers to mobilise more staff and other resources for the NHS to get through this extremely challenging period. The deployment of military personnel is welcome, but we must ensure heath and care staff have access to tests, consider short-term use of clinical students in frontline duties and try to ensure patients who don’t need to be in hospital can be rapidly discharged.

We all hope that Omicron marks “the end of the beginning” of this pandemic and that we can find a way of living with Covid, but over the next few weeks the NHS will be under intense pressure. It will need support, but this must be sustained.

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