What next for our NHS?

Alicia Kennedy on managing the health aftershocks of Covid-19

Covid-19 has made us realise how much we value health and social care staff; and rely on them to keep us safe and well. Through public displays of thanks – weekly claps, rainbow posters, and huge efforts to raise money - we have given them the appreciation they deserve. Now the NHS must confront a new challenge: to maximise non Covid-19 patient care and at the same time manage the ongoing coronavirus situation. 

Before lockdown, waiting lists stood at an unacceptable 4.2 million. In March, after the government asked the NHS to rebalance services towards treating Covid-19 patients, thousands of elective surgeries were cancelled; and thousands of patients with long-term conditions, such as cancer, cardiovascular disease and diabetes, had to go without the treatment they needed.  

Versus Arthritis believe over half a million people are now waiting for hip and knee replacement. Cancer Research UK, meanwhile, estimates that with urgent two-week referrals down by 75% as many as 2,300 patients with cancer are going undiagnosed.

Two days before the lockdown, one of my closest friends was scheduled to have a cancer biopsy. The appointment was cancelled and for the last few months I have heard the fear in her voice and sensed the desperation in her WhatsApp messages. The uncertainty means every day is driven with anxiety. Is it cancer? Is it growing? Will it be harder to treat? The questions are endless. She is one of the many hundreds and thousands waiting for treatment, assessment, and surgery. The Nuffield Trust thinks waiting lists could reach 10 million by Christmas. 

Some patients chose not to have their treatment due to fear of contracting Covid-19, but the vast majority had their care cancelled as the NHS concentrated its efforts on bravely and efficiently fighting the pandemic. 

Prioritising Covid-19 patients was a tough decision but not without consequences. As well as the enormous backlog, there will be a detrimental impact on the health outcomes of those patients. Many diseases will have gone undiagnosed or will be diagnosed later than planned – in some cases too late. That will undoubtedly lead to a post-pandemic health aftershock that will put further pressure on the NHS.

The Chief Executive of the NHS Confederation has warned the Prime Minister that it will not be possible to simply and immediately ‘switch on’ services. And in a new report, Getting the NHS back on track: Planning for the next phase of Covid-19, they set out some of the ways in which the government could support local health organisations to help get the NHS back on track.

These include: an extension of emergency funding across all sectors of the NHS; longer term funding for rehabilitation and recovery services in the community; an extension on the deal with the private sector until the end of the financial year, giving the NHS vital capacity to be able to maintain social distancing; and keeping the Nightingale hospitals in case of further spikes in Covid-19.

Measures to help alleviate pressure on NHS staff are also considered a priority with, for example, a call for a review of the impact the crisis has had on staff and a request for a delay to the return of the CQC inspection regime.  The report also reiterates the importance of a fully operational and robust test, track and trace system and appropriate supplies of PPE as services are resumed.

Importantly, the NHS Confederation asks ministers to help manage public expectations about how quickly services can be restored and communicate this message loud and clear. 

To date, we have heard very little from the government about how it expects the NHS to manage the competing demands of Covid-19 and non-Covid related care in the months and years ahead. Only when it has set out a new resourced plan for the sector, can our health service properly reopen its doors.

Baroness Alicia Kennedy is a Labour Peer. She tweets @aliciakennedy07

Published 10th June 2020

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