Coronavirus: Hospitals told to prepare for ‘rebound’ of thousands of emergency patients

Hospitals have been warned they could face a “rebound” of thousands of patients needing emergency treatment after weeks of delayed care and patients avoiding hospitals.

NHS chiefs have instructed hospitals to keep extra emergency beds and staffing ready to respond to any increase in non-coronavirus patients.

In a letter to hospital managers, NHS England chief executive Sir Simon Stevens hinted the NHS may need to extend its contract with private hospitals beyond June in order to ensure it can meet demand over the summer months.

The letter, published on Wednesday, set out the next phase for the health service after the initial surge of coronavirus patients. It also said hospitals should aim to restart services amid concerns many patients have avoided seeking help – even for urgent conditions such as heart disease and cancer.

Sir Simon told bosses there had been a 37 per cent drop in emergency hospital admissions last week compared to the same week in 2019, adding: “There is therefore considerable uncertainty as to the timing and extent of the likely rebound in emergency demand. To the extent it happens, non-elective [emergency] patients will potentially reoccupy tens of thousands of hospital beds which have not had to be used for that purpose over the past month or so.”

He said hospitals should retain emergency capacity they had created for the coronavirus surge including the use of private sector and Nightingale hospitals. Work is being done to investigate how the Nightingale hospitals, which have seen only small numbers of patients, can help the NHS in the coming months.

Sir Simon said hospitals should begin planning for the level of operations and other activities they will need beyond June “which can inform discussions throughout May about possible contract extensions with the independent sector”.

He cautioned that Covid-19 was not going away: “Based on advice from Sage, we still expect to be looking after several thousand Covid-19-positive patients, though hopefully with continuing weekly decreases.”

Elsewhere in the letter, the NHS chief executive highlighted the risks to Bame staff from coronavirus and urged trusts to ensure those at risk were kept safe.

The letter also revealed plans for widescale testing and more support for the social care sector.

It said increased lab capacity meant testing was now possible for patients when they were admitted as well as diagnostics before people are discharged into care homes, where the number of deaths has threatened to overtake those in hospitals.

Testing for NHS staff who do not have symptoms is also now being rolled out.

For care homes, in addition to testing of patients coming from hospitals, staff will be given improved training in infection control targeted at smaller homes without major infrastructure or support.

The NHS is also going to launch a new community health service to support care homes and GPs from next month.

Sir Simon said the NHS had its peak at about 19,000 Covid-19 patients in hospital, but that this had started to fall by 5,000 in the past two weeks.

He said more than 10,000 former healthcare workers such as nurses and doctors had returned to the wards along with 27,000 student nurses, medics and other professionals starting their careers early alongside 607,000 NHS volunteers.