The author is CEO of the NHS Confederation, the membership body for all parts of the healthcare system in England, Wales and Northern Ireland
The UK has reached a grim and once almost unimaginable milestone: 150,000 people have now died within 28 days of their first positive test for Covid-19.
In March 2020, a senior health official said the UK would do well if it managed to keep the death toll from the coronavirus below 20,000 people. While this may seem very optimistic, very little would have predicted that two years later we would face a death toll of almost eight times as much – nor that we would still be in the grip of the virus.
The public inquiry into the pandemic, to begin work this spring, will raise fundamental questions about the role of the state in responding to the crisis.
There will be important lessons to learn. We owe it to those 150,000 people and the bereaved to address the fundamental shortcomings that meant we entered the pandemic with 100,000 staff vacancies in the NHS, dilapidated buildings, a lack of personal protective equipment and limited diagnostic testing capability compared to other countries.
The government has awarded extra funding to the health and care system, some of which were gained through a rise in national insurance. The fact that we will have to sustain an increase in real terms year after year in the future is not, as some suggest, a reflection of the shortcomings of the NHS, but merely the reality of meeting the needs of an aging population. With digital and biomedical advances, the long-term future for healthcare is bright, but boom funding makes innovation and improvement more difficult.
Right now, the focus is on getting through the third wave of coronavirus. The Omicron variant appears to be milder as previous; despite the large increase in Covid infections, the percentage of those in need of hospital care has been lower so far. And those admitted tended to require less intensive care, such as mechanical ventilation.
It has been gripped by some politicians and commentators who want to see an end to the current Plan B measures and that the country should “drive out” the rest of the pandemic.
But there are no grounds for complacency. Covid’s Hospital Admissions 17,000 surpassed in the UK, and this rate doubles approximately every 12 days. That means we are less than two weeks short of where we were at last January’s peak, when we had 38,000 patients in hospital with Covid.
And for all the optimism surrounding this variant, there is no way to know exactly how Omicron will affect the population or the NHS. Our understanding of its behavior in different demographic groups, especially among older people, is still limited.
The health service is fighting on several fronts, not least of the rapidly rising demand for emergency care, a huge backlog for operations such as hip and knee replacements, paralysis staff absence due to Covid and other diseases, and the need to deliver the vaccine enhancer program at a significant rate.
The number one concern for NHS leaders at the moment is that large numbers of their staff – sometimes more than one in 10 – are on sick leave or self-isolating. Several hospitals had to declare a critical incident due to these shortages. Despite their dedication, many NHS staff are exhausted after two years of wrestling with Covid and its aftermath.
We have called on ministers to mobilize more staff and other resources for the NHS to get through this extremely challenging period. The deployment of military personnel is welcome, but we must ensure that health and care staff have access to tests, consider short-term use of clinical students in front-line duties, and try to ensure that patients who do not have to be in hospital can be discharged quickly.
We all hope that Omicron marks “the end of the beginning” of this pandemic and that we can find a way to live with Covid, but over the next few weeks the NHS will be under intense pressure. It will need support, but it must be sustained.