The must-read stories and debate in health policy and leadership.
- Today’s integrated care model: The ‘provider collaboratives’ sharing £400m specialised services budget
- Today’s leadership breakdown: Consultants communicated with managers through solicitors as care deteriorated at teaching trust
Ready to escalate
The rising covid infection rates in parts of the UK are quickly starting to translate into hospital and critical care admissions and deaths, which means the NHS needs to start thinking urgently about how it will respond.
The last couple of months or so have been dominated by efforts to restore planned care services which were dramatically reduced during the first peak. This is the so called “window of opportunity” to start churning through electives, according to NHS England.
All involved are aware of the cost of that to people’s health and wellbeing, with very long waits for operations mounting up — there’s a view the NHS may not be forgiven if it has to go into a major shutdown again.
Sir Simon Stevens, speaking to HSJ today, said the window had so far been going well overall; despite local concern that the recovery targets are unachievable.
And now with cases rising again, and “test and trace” on the skids, local leaders are worried their restoration efforts will be scuppered.
Speaking to the HSJ integrated care virtual summit, Sir Simon said local leaders had started drawing up urgent escalation plans to respond to a “second wave” of coronavirus, but will implement them “as late as possible” to protect those restored elective services.
“[They need to] put all of that together and say, ‘what does the second wave escalation plan look like under different scenarios’.
“We obviously want to leave it as late as possible to minimise the impact on other services. The extent to which they are impacted will be a function of the overall level of coronavirus across the population.”
There is widespread determination to avoid the mass service suspensions that were seen in the spring, even if covid admissions do keep rising. But while it may be a last resort, it could be reached, perhaps in specific areas or regions.
Sir Simon said the NHS’ ability to do that would depend firstly on the level of community transmission, and secondly on the effectiveness of the test and trace effort. It may also depend, you might imagine, on the government’s view about the issue.