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NHS Confederation: Public need reassurance over NHS recovery

As we begin to emerge out of the coronavirus pandemic, the NHS faces a slow road to recovery to restart all the services which were suspended to address the virus. According to NHS Confederation, expectations must be carefully managed by the Government to maintain public confidence during this period.

The call came in a newly-published report by NHS Confederation warning the health service faces an uphill battle as it continues to manage thousands of very sick and recovering Covid-19 patients, maintain social distancing and restart services to treat cancer, stroke and heart care.

Health services are expected to initially be operating with significantly reduced capacity, with in some cases more than half of their normal capacity unavailable in order to ensure social distancing and infection control measures are maintained at their highest level to protect patients and staff. The waiting list for routine procedures already reportedly stands at more than four million people and is expected to rise, with increased demand too for social care, respiratory, psychological and other treatments in the community.

Equally, with the increased demand, health leaders will have to balance, manage and support staff who have already been through an exhaustive and distressing few months. There will need to be a robust, clear rationale and appropriate assurances to NHS staff and the wider public.

In an accompanying letter to the Prime Minister, NHS Confederation warned it will not be possible to simply ‘switch on’ NHS services immediately. Instead, it calls for a number of the Government to take a number of steps to help support the restarting of services across the NHS:

• An extension of emergency funding across all sectors of the NHS, given significant extra demand across all services. Longer term funding will be needed for rehabilitation and recovery services in the community, including for mental health, to manage patients at home and in the community.
• Putting in place an ongoing arrangement with the private sector – this will be vital to provide capacity to respond to the backlog of treatment.
• A review of the impact of COVID-19 on the NHS and social care workforce given the unprecedented pressure staff have been under
• A delay in returning to the inspection regime of the CQC to take into account the positive changes that have been achieved as a result of the lighter touch approach to regulation that has been in place during the pandemic.
• A commitment to acknowledge and address health inequalities wherever possible through upcoming guidance and policy reform.
• Clarity over when there will be a return the greater autonomy local organisations had before COVID-19 returned, as we move from Level 4 to Level 3. This should be considered as part of a wider move to less central command and control when the pandemic has subsided.
• A call for assurance that there will be a fully operational and robust test, track and trace system, as well as appropriate supplies of personal protective equipment (PPE), as services are resumed.

The NHS Confederation has published its report ahead of updated guidance from NHS England and NHS Improvement on how the next phase of the NHS response to the pandemic will be managed.

Niall Dickson, Chief Executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “NHS leaders understand the need to ease lockdown and get the country ‘back to work’. Part of this will involve restarting diagnostic screening, routine operations, outpatient appointments and other care, but we need to do this safely.

"Our members are aware that the virus is still with us and of the real risks of outbreaks in care settings. That is why we need a robust plan, communicated clearly, and trace to make sure the NHS can prepare safely, protecting its staff, patients and the wider community as it does so.

“Political leaders have a vital role to play in reassuring the public that every step possible is being taken to manage the virus, while safely bringing back services that had to be paused. Retaining, public confidence and trust in the NHS will be vital over the next few months.

“The NHS wants to get back to providing these vital services - the virus has inflicted pain and suffering throughout the UK, but we also know the measures to combat it have come at a terrible cost to those who have not been able to access the care, treatment and support they need and to many whose conditions have gone undiagnosed.

“There is a real determination to rise to this challenge, but it will need extra funding and capacity, not least in rehabilitation and recovery services in the community where so much of the coming demand will be felt.

“But we also need to send a clear message that it will take time to recover from this shock and we need patience and understanding and from politicians, assurances, support and realistic expectations.”