NHS bosses warned not to shut down normal care if second wave of Covid-19 hits

More than one million fewer patients underwent planned surgery in April, May and June due to mass hospital discharges and their suspension of usual services amid the pandemic
PA
David Child7 August 2020

Thousands of vulnerable patients would be left "stranded" and at risk of early death if NHS bosses shut down normal care in response to a second wave of Covid-19, doctors have warned.

Doctors’ and surgeons’ leaders on Thursday urged managers to keep the day-to-day health service running. At the start of the UK's outbreak in March thousands of appointments were cancelled to help hospitals cope with the an influx of coronavirus patients.

“The NHS must never again be a Covid-only service. There is a duty to the thousands of patients waiting in need and in pain to make sure they can be treated,” Professor Neil Mortensen, president of the Royal College of Surgeons of England, told the Guardian.

Dr Chaand Nagpaul, chair of council at the British Medical Association (BMA), said: "We cannot have a situation in which patients are unable to access diagnostic tests, clinic appointments and treatment which they urgently need and are simply left stranded."

“If someone needs care – for example for cancer, heart trouble, a breathing condition or a neurological problem – they must get it when they need it," he told the Guardian.

The pair's comments come amid mounting fears of a second wave in the UK this winter and concern over the long-term impact of the disruption to NHS services.

Between 30,000-40,000 patients could not start planned cancer treatment and more than one million fewer patients underwent planned surgery in April, May and June due to mass hospital discharges and their suspension of usual services.

The pausing of services, combined with patients' reticence to enter hospitals, has been linked to some 12,000 excess deaths in England in recent months, according to data collected by the Office for National Statistics (ONS).

The deaths were not linked to Covid-19 directly but instead caused by a range of conditions, such as heart attacks.

“While not publicised in the daily briefings, these [12,000] excess deaths are just as much a tragedy and loss to loved ones as those occurring from the virus," Dr Nagpaul said.

Professor Mortensen added: "The NHS had to stop almost all planned surgery at the beginning of the Covid crisis, and we just cannot let that happen again."

"Things will need to be done differently in the face of any further spike,” he said.

Looking ahead, Professor Mortensen suggested hospitals should look to establish "Covid-lite" sites to enable surgeons to resume common operations - such as hip and knee replacements - and utilise the NHS's £400-a-month deal with private hospitals to ensure patients are not left stranded again.

Dr Nagpaul suggested the NHS could look at using the seven Nightingale hospitals as extra capacity for non-Covid care to avoid worsening the existing backlog.

"Delaying further care during a potential second wave could mean that we are constantly trying to catch up with the missed care,” he said.

But a spokesperson NHS England refused to rule out a second shutdown.

“Even at the height of coronavirus, for every one Covid patient in hospital, there were two other in-patients being treated for other conditions, so it is factually untrue to suggest the NHS was ever a ‘Covid-only service’,” the spokesperson said.

“More than five million urgent tests, checks and other treatments took place during the peak of the virus, including 65,000 patients getting vital cancer treatment. How the health service has to respond to any further Covid peak will partly depend on just how big it is.”

Last week, Simon Stevens, chief executive of the NHS in England, wrote to all hospitals asking them to “accelerate the return to near-normal levels of non-Covid health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter”.

But the NHS Confederation said that desires to get the NHS back to near-normal levels of service before winter will be a “big stretch”.

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