The NHS is facing an unprecedented struggle with the rise of Omicron and the government’s refusal to implement further restrictions, according to the CEO of NHS Providers.
Chris Hopson, who heads up the association of NHS trusts and foundation trusts, warned on Wednesday that the NHS is now “stretched like never before” – despite Downing Street’s repeated claim that the service faces similar pressures every winter.
At least 24 NHS trusts in England – out of 137 – have reported a “critical incident”, meaning even priority services now may be under threat and unable to go ahead, as staff are overwhelmed.
Why not every region will be able to respond like London
Hopson tweeted: “London [is] still showing lower hospitalisation growth, but [there are] growing concerns that the assumption the rest of the country will match London’s pattern may be wrong.”
Omicron took hold of the capital first when it was detected in the UK. It swept through London in December, with one in 10 of the city’s population testing positive during the last week of 2021.
The numbers now seem to be declining, suggesting London survived the peak of the virus without reaching the same level of hospitalisations seen during previous infection waves.
However, Hopson warned that the infections are now starting to reach the older generations – which could trigger more hospitalisations.
The effects of indoor mixing at Christmas and at the New Year – as well as this week’s return to school – are yet to be felt too.
Hopson suggested people should not assume the rest of the country was going to follow the pattern set in London, as each individual health or care system has different demographics and sickness absences which will impact how each region copes with the wave of the virus.
“Trusts will start from different positions in terms of caseload,” he explained.
“Several saying they’ve started with higher bed occupancy (both Covid and non-Covid) than many London trusts.”
He said there were also issues with the workforce, including the ability to access agency workers.
“Many trusts already had workforce gaps pre-Covid so [are now] less resilient when absences strike,” Hopson added.
He pointed out that social care is very different across the UK too, meaning there could be discharge delays with patients taking up hospital beds when they should be moving onto the next stage of their recovery.
The cumulative impact on NHS staff
Hopson claimed NHS leaders and staff are working hard to avoid the words “overwhelm” “tipping point” and “crisis”, and that patients should still come forward for treatment if they think they need it.
Even so, patients will have to wait longer for urgent care, for ambulances to arrive, to be seen to in A&E and for emergency calls to be answered as so many members of staff are off work.
NHS staff absences in London increased by 150% week-on-week in the seven days leading up to December 19, according to data from the health service.
Not only are many employees absent after to contracting Covid themselves or because they are isolating, but the backlog of patients from previous lockdowns, the prioritisation of the vaccine rollouts and influx of Covid hospitalisations means the workload is becoming unsustainable.
Staff are suffering with the emotional burden of the crisis too.
Hopson pointed that the NHS frontline leaders and staff are buckling under the pressure as they continue trying to provide the “best possible care to all those who need it”.
He claimed there were three large pressures emerging at once: “Rising Covid hospitalisations and growing staff absences on top of large non-Covid pressure.”
Is there a solution?
Hopson concluded: “This keeps coming back to the same underlying strategic point. Pre-Covid NHS didn’t have enough capacity to meet demand.
“And we are asking our staff to work harder and harder to try to close gap. This is unsustainable. These issues must be addressed for the long term.”
The only response, he said, is creating extra capacity with virtual wards, surge capacity, building super surge hubs like the Nightingales, maximising discharge efforts for hospital patients, and redeploying staff and re-prioritising services.
He also pointed out that “consistent and timely access” to PCR and lateral flow tests is essential too, amid shortages of tests in the UK.