Time to put in place proper infrastructure to provide care for both Covid-19 and non-Covid-19 patients alikeby Jon Ashworth / July 13, 2020 / Leave a comment
The NHS avoided the kind of devastating scenes that took place in struggling Lombardy hospitals, witnessed by us on our TV screens. For that we can thank NHS staff, whose extraordinary efforts were until recently rightly celebrated on doorsteps across Britain on Thursday nights. They must now be recognised with decent pay, conditions and support.
But “protecting the NHS” has come at an immense human cost: thousands of patients discharged into care homes to free up general and acute beds, the mass cancellation of elective surgery, and the delay of vital treatments, not to mention the unquantifiable mental health problems festering as a result of the anxiety and loneliness associated with lockdown.
The waiting list for treatment—already unacceptably high—is predicted to rise to a staggering 10m by Christmas. Emergency department data shows numbers presenting at A&E with symptoms of a possible heart attack halved throughout early lockdown; one in four people with lung conditions such as COPD have had either a GP or hospital appointment cancelled.
Cancer specialists warn that two million people are waiting for cancer screening, tests or treatment, while cancer referrals are down 60 per cent and around 1,600 cases are currently left undiagnosed every month.
This growing mountain of unmet clinical need is a national emergency and will lead to worsening health conditions for people and premature deaths unless tackled. For that we must equip the National Health Service with the necessary resources. It cannot simply remain a National Covid Service.
With infection and hospitalisation rates for coronavirus currently falling, we now need to put in place the infrastructure to provide care and treatment for both Covid-19 and non-Covid-19 patients alike. That means a mass regime across the health service to test all NHS staff weekly, and to test patients admitted for non-Covid-19 treatment. Given we know that around 20 per cent of Covid-19 infections come from within hospital, this is urgent. A recent study from Imperial College London claimed that weekly testing of healthcare workers is “estimated to reduce their contribution to transmission by 25-33 per cent, on top of reductions achieved by self-isolation following symptoms.”
Capacity constraints have meant hospitals throughout the crisis have run at lower levels of occupancy than normal. This isn’t sustainable, and will mean some hospital trusts may now need to physically reconfigure sites to allow for Covid-19 and non-Covid-19 hospital buildings.
“Around 1,600 cancer cases are currently left undiagnosed every month”
But the NHS confronts this challenge from the worst possible starting point. Years of austerity have seen billions cut from hospital maintenance budgets, leaving trusts with a £6.6bn repair bill. It has meant hospitals left scrambling to cope with ward ceilings falling in or sewage pipes bursting and with faulty, out-of-date equipment.
We have had years of stringent finances and chronic staff shortages, with around 15,000 beds lost since 2010. Lack of investment has left us with among the lowest numbers of MRI and CT scanners per head in the OECD.
Demands to balance budgets have forced local NHS bosses into selling off land and buildings that could now be used. Last year, over 800 hectares of NHS land were put on the market. A new approach is needed that delivers the large-scale diagnostics testing, beds and investment for building works necessary.
Time is pressing. A second wave of the virus, coinciding with winter flu, could be devastating without action. We know the UK already shamefully stands out, having one of the worst tolls in the world, with 65,000 excess deaths, over 50,000 of those deaths associated with coronavirus and 13,000 of them in care homes. Ministers have been slow and disorganised in their response to the pandemic. They must learn from their mistakes and show urgency now.