NHS leaders and staff risk being abandoned by the government unless new ‘living with Covid’ plan is delivered

The Government has been urged to revamp its ‘living with Covid’ plan as NHS leaders warn the government risks abandoning the health service in the face of continued high infection rates and hospital admissions.

Since the ending of the remaining Covid restrictions, the UK has been in the grip of another spike in Covid cases. This has resulted from the Omicron BA.2 variant. While the severity of the virus has been reduced due to the success of the vaccine roll-out, we continue to see high numbers of people with Covid. More than 20,000 patients are now in hospital with Covid (or who have Covid but are in hospital for other reasons). Alongside high staff absences, this continues to pose huge operational challenges for the NHS and is harming efforts to reduce waiting times in other areas. 

The continued threat posed by Covid, alongside critically high demand for emergency care services and lengthening waiting lists, compounded by high staff absences, has led many NHS providers to declare critical incidents. In the past week, around 20 accident and emergency departments in England have issued diverts, with patients having to be taken elsewhere. The NHS is operating at extremely high bed occupancy levels and continued staff absence rates are well above the average for this time of year. 

With the very high rates of Covid still having a major impact on the delivery of health services and slowing down efforts to reduce large waiting lists, the NHS Confederation is calling for the Government to reconsider its ‘living with Covid’ plan and introduce mitigating actions that will help avoid further critical incidents being declared at the NHS front-line.

NHS Confederation chief executive Matthew Taylor said:

“NHS leaders and their teams recognise the need to ‘live with Covid’ as we move towards what the government hopes will become an endemic stage of the pandemic. However, they report a clear disconnect between the Government’s ‘Living with Covid' plan and the realities they are facing at the NHS front line.

“The brutal reality for staff and patients is that this Easter in the NHS is as bad as any winter. But instead of the understanding and support NHS staff received during 2020 and 2021, we have a government that seems to want to wash its hands of responsibility for what is occurring in plain sight in local services up and down the country.

“No 10 has seemingly abandoned any interest in Covid whatsoever. The Treasury has taken bites out of the already very tight NHS budget, while soaring inflation means the NHS settlement is now worth less. It is now unclear that anyone in the centre of government feels the unfolding NHS crisis is their responsibility.

“NHS leaders and their teams feel abandoned by the Government and they deserve better.

“We have been promised a ‘living with Covid’ plan yet all we have is a ‘living without restrictions’ ideology.

“We urgently need stronger messages to the public on taking precautions to reduce opportunities for the virus to spread and getting booster vaccinations. We need to be realistic about what the NHS can be expected to achieve in the face of very high Covid levels, rising demand for urgent and emergency care, and backlog pressures. We also need proper Covid funding to continue until the virus is genuinely under control and we need a medium-term plan for reducing the risk of respiratory diseases including mask wearing and ventilation in public spaces.

“Covid is far from over as ministers appear to want to believe and we urge them to get a grip on this – both for the current spike in infections but also for potential future ones.”

The NHS Confederation is calling for the following actions:

• NHS leaders seek honesty in government messaging to the public about the scale of the current impact of Covid-19 and are concerned that the communication approach is tending to mislead the public and discourage them to take steps to reduce transmission, contributing to the very high rates of Covid-19.
• The Government should reinvigorate its public information campaign on Covid to be clearer about the rates of infection and impact, while encouraging people to resume behaviours that have previously been effective in keeping infections down. That includes a renewed focus on encouraging mask wearing in crowded public spaces given adherence has reduced, opting for meeting outdoors and in well-ventilated places whenever possible, and isolating when unwell. This information campaign should also support messaging that encourages the public to make the best choices when it comes to accessing health care. For example, only visit A&E departments when it’s an emergency and use other services, such as 111 and community pharmacy, for more minor concerns. 
• NHS infection prevention control measures should be reviewed to better balance risk, empower hospitals and other providers to make good decisions and free up more capacity in the NHS to treat non-Covid patients.
• We need to see a review of elective and other key NHS targets commensurate with the ongoing pressures caused by this Covid crisis. The NHS is charged with delivering waiting time recovery targets that were set when the expectation was that the threat from Covid would largely be over. The targets did not envisage the BA.2 variant, which is currently manifesting in over 20,000 patients currently in hospital with Covid (or who have Covid but are in hospital for other reasons). The ongoing disruptions caused by Covid is slowing down the NHS’ attempts to reduce waiting times and there needs to be greater awareness and understanding of this.
• Additional funding from government to cover the direct costs of Covid is required given the ongoing pressure from treating Covid patients. For example, the NHS is being asked to absorb the costs of lateral flow tests, which is estimated to cost several hundred million pounds. This money in effect cannot be spent on extra staff or on treating patients. The government should reconsider its request for the NHS to absorb the costs of lateral flow tests until the infection rate and admissions have reduced significantly or be upfront with the public that some performance targets around elective care will not be hit.

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We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.