Tougher choices ahead for the NHS in the new year

The prime minister, Boris Johnson, decided were would be no need for further Covid-19 restrictions before the new year, emphasising the rate of hospitalisations did not warrant it.

Of course, the PM’s decision came before the consequences of Christmas mixing will have shown in hospitalisation data.

While he has faced a backlash of sorts, organisations representing NHS hospitals have yet to make strong calls to stricter resections - although they’ve said the government must be poised to do so if things take a turn for the worse.

With the number of Covid patients in hospitals increasing by 1,000 a day since Christmas, post-new year admission levels combined with emergency pressures may well force a stronger stance.

As reported by The Independent, NHS national teams warned hospital chiefs this week they should “prepare for the worst but hope for the best” admissions to continue to climb for at least the next 10 days – brining us to a peak in the second week of January.

Some commentators have pointed out that the numbers of Covid patients in hospitals– which now stands at 12,395 – is around half the level at this point last year, during the Delta wave.

It is true the NHS not in the same position as last year, for one thing we’re not seeing the same stories we did in December 2020 of critical care patient being ferried about as Covid fills ICUs. However, the NHS is facing a plethora of pressures which have only intensified in the last 12 months. This means we should be cautious in comparisons to last year when deciding whether the NHS is being “overwhelmed.”

This time last year the NHS had put almost all planned operations on the back burner – only those most urgent cancer ops were really being done.

Following the Delta wave, although planned operations were back, the NHS had little time to really tackle its backlog as a “winter-style” crisis began to hit in the summer. This means over the current winter period hospitals are desperate to keep operations going for patients who will have become more acutely ill and cannot wait any longer.

Since the summer, healthcare services have faced new records waits in A&E, ambulance delays, discharge difficulties – and is heading into 2022 in an arguably worse position in terms of non-Covid pressures.

On a more positive note, NHS hospitals themselves did learn a lot from the Delta wave in terms of having to expand their beds and redeploy staff at speed.

However, the key game-changer this year will be levels of staff sickness. According to an analysis of leaked data by the Health Service Journal, absence rates across the NHS are higher than they were this time last year, reaching 7.8 per cent. This is higher than in any wave according to national NHS data.

It’s important to note that this data won’t include primary care and GP services, which is important as these services are reportedly buckling – with little to no safety net.

The perfect storm of a highly-infectious variant, shortages in the Covid testing world, and increased burnout (driving staff sickness) could hit NHS exactly when Covid admissions are at their peak in the new year.

If this happens it will invariably mean the NHS is likely to become just as “overwhelmed” as last year or worse. Planned operations, emergency care, GP services and over patient safety will all suffer if the workforce becomes too stretched.

These next two weeks could force some very difficult decisions to be made within the NHS