We are now in the highest COVID-19 alert level and we know there is a material risk of some NHS services being overwhelmed.
Despite this, there is a vocal minority of commentators who believe the threat from COVID-19 is overplayed. This has manifested itself in falsehoods appearing on some national broadcast outlets, with social media being used to amplify what we believe to be a dangerous rhetoric. These falsehoods could encourage some members of the public to choose not to adhere to the lockdown restrictions, while it is also damaging the morale of NHS staff who have been battling the pandemic for almost a year.
As the membership organisation that brings together, supports and speaks on behalf of all healthcare organisations in England, Wales and Northern Ireland, we will continue to use our platform to promote greater understanding and awareness of the severity of the challenge facing frontline services.
That is why we have launched our #CovidEmergency campaign. The campaign is informed by the following truths that we hold to be self-evident:
The COVID-19 emergency is real
The pandemic has brought the NHS in some parts of the country to the brink. The situation is dynamic and the national lockdown restrictions will begin to stem the tide, but there is a material risk of some NHS services being overwhelmed. The pressures are particularly being felt in London, the South East and East of England, but other parts of the country are experiencing a rise in COVID-19 admissions.
The extra demand on the NHS is real
Fuelled by the new and more virulent strain of the virus, there are many more patients with COVID-19 in need of a hospital bed now (16,059 as of 23 February) than there were at the April 2020 peak (21,684 on 12 April). A significant number of these patients require mechanical ventilation to help them breathe (2,118 as of 24 February). The pressure is being felt right across the health system in other key services beyond hospitals, including ambulances, community services and mental health providers.
This is unlike any ‘normal’ winter pressures
Historical data on patients admitted to intensive care units with flu are significantly lower than the numbers of patients with COVID-19 currently in intensive care.
Bed occupancy is a misleading measure
Some commentators have cited lower bed occupancy rates compared to previous years as an indicator of hospitals not being under any more pressure than normal. This is misleading. The NHS has significantly expanded its adult critical care capacity this winter and there are now over 2,000 more adult critical care beds across England and Wales compared to last year that are being used to respond to rapidly rising demand – so-called ‘surge capacity’. However, using current bed occupancy data to measure against previous years’ is not a like-for-like comparison. For example, in any given week last year, a hospital may have had 50 critical care beds occupied by 46 patients. This would give a 92 per cent occupancy rate. That same hospital might now have 80 critical care beds occupied by 70 patients. This gives an occupancy rate of 87.5 per cent. Although this rate is lower than last year, there are more patients this year occupying more beds.
The NHS is being hampered by reduced capacity
With the exception of adult critical care, the NHS has fewer available beds than last year. This is because wards have to remove beds to allow for social distancing and greater infection control. The situation is being compounded by higher rates of staff sickness, especially in the areas hardest hit by COVID-19. It is not unusual for absence rates to now be double the usual level. All of this results in much greater pressure on frontline services.
The NHS is not 'wasting' spare capacity in the Nightingale hospitals
A common complaint is that the NHS should make greater use of the Nightingales to cope with this extra demand. However, the Nightingales were always intended as a last resort as they require staff to be redeployed from other services to work in them. The NHS is close to full capacity in some parts of the country and is now opening some of the Nightingales. Manchester and Exeter were already operational, and they have been joined by the London Nightingale. The situation will continue to be monitored closely to see if others will need to be opened.
This page, and our #CovidEmergency infographic, will be updated regularly with the latest information.
The NHS Confederation stands in support of our members working across hospital, community, mental health and ambulance trusts; primary care networks; clinical commissioning groups; and integrated care systems. They are playing a vital role in responding to this unprecedented pandemic. However, they are being let down by a rising tide of disinformation and falsehoods that are not only undermining their efforts and morale, but which also risk public compliance with the lockdown restrictions.
We know the situation facing the NHS is real and serious. The NHS is working on the edge of what is safe and sustainable and has been for a number of weeks. We must get the level of infections down so that the NHS can deliver the care that people need and expect. The main way of doing that is by ensuring we all adhere to the rules and break the chains of transmission. This will alleviate the pressure on the NHS and, ultimately, move the country out of lockdown.
We will do all we can to promote greater understanding and awareness of the extreme pressure the NHS is under and encourage others to do so via #CovidEmergency