NHS facing 'impending winter storm' amid Covid pandemic

A national strategy to manage hospitals during the second wave of Covid-19 is needed to ensure the NHS stays afloat through the “impending winter storm”, leading physicians have said.

They warned that, unless Covid-19 is managed effectively in the country’s hospitals, “we cannot safely provide essential and elective care”.

The strategy must agree how to balance the competing pressures of treating patients with Covid-19 and those without who need urgent care, and elective work, the heads of three medical and surgical colleges in Scotland said.

They also said that health boards must be given the flexibility to plan the right balance for themselves as the needs of different parts of the country can vary greatly over time.

In a letter to The Times they wrote that their members are seeing a rapidly rising number of patients with Covid-19 being admitted to hospitals.

They said the significant increase in the number of seriously ill patients is happening as many hospital services have reopened following the initial pause in services in the spring, and has “placed huge pressures on an already exhausted workforce”.

In the letter, the presidents of the Royal College of Physicians and Surgeons of Glasgow, the Royal College of Physicians of Edinburgh and the Royal College of Surgeons of Edinburgh welcomed measures being implemented to reduce community transmission.

However they wrote: “In addition to this, we also need to agree a national strategy for balancing the competing pressures of treating patients with Covid-19, those without Covid-19 who need urgent care, and elective work.

“We must strike a balance between the needs of these three groups of patients if we are to keep the NHS afloat throughout the impending winter storm.

“These should not be competing efforts because, unless we effectively manage Covid-19 in our hospitals, we cannot safely provide essential and elective care.

“As we have seen already, the needs of different parts of the country can vary greatly over time, so health boards must be given flexibility to plan the right balance for them throughout the winter period.”

In the letter, published in full on the Royal College of Physicians and Surgeons of Glasgow website, they said this must all be aligned to an improved testing strategy for NHS staff so that services can continue to be provided as close to capacity as possible.

“Only by developing and implementing a strategy that delivers these elements can we ensure that the NHS in Scotland will effectively weather the storms ahead.”

The letter is signed by Professor Michael Griffin, president of the Royal College of Surgeons of Edinburgh, Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow, and Professor Angela Thomas, acting president of the Royal College of Physicians of Edinburgh.

On Tuesday, First Minister Nicola Sturgeon announced that Scotland had recorded 28 deaths from coronavirus and 999 positive tests in the past 24 hours.

There were 1,254 people in hospital confirmed to have the virus, up by 29 in 24 hours, with 92 in intensive care.

A Scottish Government spokeswoman said: “We recognise the risks highlighted by the Colleges and have been working with stakeholders to plan and prepare for this winter.

“As set out in our recently published Winter Preparedness Plan, our overriding priority continues to be that the NHS is not overwhelmed in the coming months.

“We continue to work closely with all health boards to ensure they have robust plans in place to deal with a range of pressures on capacity, including Covid-19.

“We also need to prepare for the possibility that some resumed services may have to be paused again, should we need to redeploy capacity to deal with the Covid-19 resurgence or manage other winter pressures.

“Further guidance will be issued shortly to boards, covering decision-making framework, clinical prioritisation and mutual support.”