Senior medics call for urgent preparations for “winter like no other” in the NHS

Senior medics have called for urgent preparations to be put in place now to contend with a “winter like no other” in the NHS this year as hospitals face the prospect of managing COVID-19 alongside seasonal viruses and other pressures.

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said action was needed to “protect staff so they can continue to care for patients” ahead of what he anticipates will be an “onslaught”.

He warned that concerns raised by senior government advisers about a second wave of COVID-19 combined with seasonal viruses, the effects of delayed presentations and worn out staff could have “severe consequences.”

“The greatest concern now is around the coming autumn and winter and we have already heard senior scientific and medical advisers Sir Patrick Vallance and Dr Jenny Harries say that winter will be extremely challenging for the NHS.

“In particular that we may have a second wave of COVID-19 simultaneously with the usual seasonal rise in other viral illnesses such as influenza and norovirus together with all of those who have put off coming to hospitals as long as they possibly could during the first wave.

“These predictable stresses will be further exacerbated by the ongoing need to keep people with coronavirus separate from others to prevent transmission, with segregated wards effectively reducing immediately available beds.”

Dr Scriven said part of the planning strategy should look at a permanent reduction in the footfall through hospitals to help maintain focus on the importance of infection control as a significant part of the effective running of hospitals all year round.

“Positively, the recent and current focus on infection control and distancing can only help reduce the spread of infections associated with the high attendance, footfall and high bed occupancy rates we routinely see, particularly so during winter.

“The current reduced bed use in some areas help to reduce the spread of infection but the clock is ticking on that option as we move through the year, so we need to think about what measures will be incorporated into planning now for what will be a likely horrendous end of the year.

“As part of this, in addition to the reduction in activity through telephone and online outpatient clinics, I would strongly urge permanent reduction in unnecessary footfall in hospitals from large groups of visitors, on-site meetings, conferences and public events.

“We know influenza and norovirus spread at will through hospitals following community transmission, so looking at how we can take some of the current changes forward permanently would be a positive step towards reducing infection and, in turn, pressures on hospitals and staff.”

Dr Scriven said it was also imperative government and NHS leaders recognise the “neglect” of staffing levels and what steps will be taken to care for the wellbeing of staff.

“As we move through the pandemic we need to consider what comes next and we must work out – and see evidence – of how we will give our front door teams much needed time to recover both tired minds and bodies.

“We need government and hospitals trusts to act now and recognise that through immense efforts the NHS has managed to look after many thousands of people, but this has only been made possible through mass changes and cancellations affecting planned care.

“The problems likely to be associated with that could be exacerbated by a winter like no other which, coming after years which have seen each winter be labelled the “worst ever” could have severe consequences.

“We need to see urgent action to protect staff so they can continue to look after all of those in need when they need it as the NHS is for life, not just a pandemic.“

Dr Susan Crossland, president of SAM, added: “There is a cautious welcome that the initial wave has been controlled and things feel a little more like normal but the threat of winter, flu, norovirus and coronavirus means that we need to be better prepared than ever – and that is something we haven’t been for a number of years now.”