Enact ‘Plan B plus’ to avoid ‘stumbling into winter crisis’

The NHS is seeing worrying increases in coronavirus cases in its hospitals and the community at a time when it is preparing for a busy winter period, its staff are close to burnout, and it is being expected to recover many of its services that were disrupted by the pandemic.

The NHS Confederation is warning that the extent of this recovery could be at risk without preemptive action over winter from the government and the public.

Last month, the government set out its COVID-19 winter strategy, which focused on building the population’s defenses through vaccinations and other pharmaceutical interventions, as well as test, trace and isolate measures, and public health messaging.

Within that, a ‘Plan B’ would be enacted if pressures on the NHS were deemed to be at risk of becoming unsustainable. Additional measures could include clear communications to the public that the level of risk has increased, introducing certificates for people’s COVID-19 vaccine status, and legally mandating people to wear face coverings in certain settings, in addition to considering asking people to work from home if they can.

Many of these measures, particularly around mask-wearing and COVID-19 certification, are already common in parts of Europe where the prevalence of the disease is lower.

The membership body is calling for these actions to be introduced sooner rather than later so that if cases of coronavirus still rise to worrying levels, the government can then introduce tougher measures, if needed.

Alongside this, the NHS Confederation believes that this should go further with a ‘Plan B plus’, calling on the public to mobilise around the NHS and do whatever they can to support frontline services this winter. This could include by:

• Getting vaccinated, including booster shots when invited.
• Turning up for scheduled healthcare appointments on time.
• Using frontline services responsibly, such as by only calling 999 in emergency situations and accepting appointments with primary care professionals other than GPs, such as practice nurses and community pharmacists, as well as remotely from both primary and secondary care, if offered and suitable
• Volunteering to support the NHS and joining or returning to the workforce, if eligible. 

Matthew Taylor, chief executive of the NHS Confederation, said: “The NHS has shown that it has been there for its patients throughout the pandemic and is working hard to tackle the increased demand for its services, with 1.1 million procedures and 25.5 million GP appointments delivered in August.

“The NHS is preparing for what could be the most challenging winter on record and it will do everything it can to make sure its services are not disrupted but these outside pressures are not solely within its gift to influence. As cases of coronavirus continue to climb, alongside other demands on the health service and pressure on staff capacity in both the NHS and social care, leaders are worried about what could be around the corner.

“There is a crucial opportunity for the public to pull together and show extra support for the NHS by behaving in ways that will keep themselves and others safe and also safeguard stretched frontline services for those most in need.

“It is time for the Government to enact Plan B of its strategy without delay because without preemptive action, we risk stumbling into a winter crisis. Also, health leaders need to understand what a ‘Plan C’ would entail if these measures are insufficient.

“The government should not wait for COVID infections to rocket and for NHS pressures to be sky high before the panic alarm is sounded.

“Additional investment has been given to the NHS to support its recovery and leaders are committed to putting that to best use as rightly, the public expects a return on its investment but if the government fails to get a grip on the rising cases of coronavirus and other illness, this could be put at risk.”

Confirmed cases of coronavirus in the UK have exceeded 40,000 for the last seven days, with 43,738 recorded today (Tuesday) and 49,156 on Monday. The last time cases were in this bracket was in mid-July. Also, English hospitals have seen a 10% increase in Covid-19 cases in the last week, with 7,749 people reported at the last count. Deaths are averaging around 120 a day but today there were 223 deaths within 28 days of a confirmed positive diagnosis.

Vaccinations have played a significant role in keeping these numbers lower than they could have been and were in previous waves of the pandemic, with the NHS currently supporting booster shots and flu vaccinations to more patients than ever, as well as supporting Covid-19 jabs for 12- to 15-year-olds. Over 83 million jabs have been given in England so far.