NHS faces a ‘perfect storm’ this winter, leaders say

Respiratory illnesses and further surges in Covid-19 could create a “perfect storm” that derails plans to deal with the backlog of NHS care, health experts are warning.

A survey of trust leaders in England by NHS Providers found that 78% are extremely or moderately concerned about the operational pressures their trust will face this winter.

Some said the squeeze will depend on how much flu and Covid-19 is circulating, while others said they were already seeing an increase in demand for urgent and emergency care.

Some 88% said it was likely that another surge in Covid-19 cases in this financial year will result in extra pressure.

It comes after Health Secretary Matt Hancock pledged a significant flu vaccination drive this winter as experts predict a bad flu season following lockdown restrictions and less mixing.

The chief operating officer of a community trust in the South East told NHS Providers: “I am worried that we will have a difficult flu season and we will have a run on the beds.

“This will destabilise the elective (planned treatments) recovery which will be very concerning given the length of time patients have already waited.”

NHS Providers received 155 individual responses to its survey from 113 separate NHS trusts.

Some 33% of responses were from chief executives, 18% were from chief operating officers and 16% were from medical directors. Others included nursing and HR leaders.

Asked how concerned they were about disruption to clearing the NHS backlog for treatment owing to the need to prioritise Covid-19 patients and A&E, almost three quarters (73%) of respondents said that they were extremely (40%) or moderately (33%) concerned.

Mental health and acute trust leaders agreed that demand for mental health services already exceeds capacity, the survey found.

Almost half (48%) of respondents said they have seen evidence of staff leaving their organisation due to early retirement, Covid-19 burnout or other effects from working in the pandemic.

A further 42% said they had not seen this while 10% did not know.

Deputy chief executive of NHS Providers Saffron Cordery said: “Our survey reveals the sheer scale of the challenge facing trusts right now.

“They are battling on multiple fronts as they try to recover care backlogs, deal with increased demand for emergency care and treat patients with Covid-19.

“This is difficult at the best of times but, as we saw last year, could become even more challenging during the hard winter months, particularly with the expectation that flu will return and there will be increased respiratory viruses among children.

“Trusts are committed to clearing the backlog of care that built up during the pandemic.

“We are confident vaccines are breaking the chain between infections and hospital admissions, but the reality on the frontline is that even a small increase in Covid-19 admissions or emergency care pressures could affect our ability to deliver non-Covid services.”

She called for action from the Government, including short-term capital funding “so trusts can direct it to the services that need it most”.

She said there also needs to be funding to improve the discharge of patients and proper winter planning to minimise any risks.

“We know the NHS faces a perfect storm of Covid-19, flu and other respiratory illnesses as well as a growing backlog of care,” she added.

“We must act now.”

An NHS spokesman said: “Throughout the pandemic, NHS staff have worked tirelessly to face the biggest public health emergency in NHS history, responding to demand for services by expanding hospitals’ critical care capacity by 50%, managing admissions through mutual aid between hospitals and working with the independent sector.

“As we battle the global pandemic, we continue to use these tried and tested robust measures and we working with trust leaders to ensure hospitals continue to offer patients the care they need while tackling the waiting list backlog and vaccinating the country against Covid, as well as looking ahead to winter.”