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NHSE to Restart Immediate Non-Covid Care


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UPDATED

25 MAY 2020


The NHS has a six-week action plan in place for prioritized healthcare service areas as it is to resume a range of urgent non-coronavirus services.

Addressing local chief executives in a letter, NHSE bosses stated that hospitals – over the next six weeks – must “release” their capacity back from treating Covid-19 patients to “redistribute” spaces suitablefor other types of healthcare services.

But the NHS cautioned it would be “sensible to ready extra capacity, already brought on line, including quick access to Nightingale hospitals and independent hospitals”.

This is partly to ensure fully steadied service, for a surge in emergency admissions that have severely dipped in recent weeks. “It clearly indicates we need to maintain our proven ability to repurpose and step up capacity immediately on both local and regional level, should it be in demand again”, reads the letter.

The letter, in a cautious tone on how quickly the healthcare services would get back to the pre-pandemic stage of elective work, reads that the centre would “continue to supply new ventilators to trusts in the coming weeks to support the surging critical care capacity should it be required further in future, while gradually restoring recovery suites and operating theatres to normalcy.

It said local NHS organizations should “work in cooperation with the regional teams across local systems over the next 10 days to analyse if you have enough capacity for at least some routine elective care. Such an assessment needs to take into account availability of personal protective equipment, associated medicines, consumables, blood and other required supplies”.

The service should also be in keeping with the needs for “covid-19 support and aftercare in community health services, mental health and primary care”, while GPs have already received instruction “to continue to classify and proactively reach out to the high-risk patients with on-going healthcare needs”.

The letter follows Matt Hancock, Health Secretary, announcing at the daily briefing on the issue yesterday that the NHS would increase their “efforts for restoration” this week.

Stephen Powis, Medical Director at NHSE, stated at the daily briefing that the restoration process on a regional level would be different “due to different infection rates and different ways taken by various organizations to intensify their response to handlethe recent surge”. However, the guidance was clueless to how variation on a local level would be accounted for.

Chief Operating Officer Amanda Pritchard and NHSE chief Sir Simon Stevens sent a letter mentioning some much-needed actions including:

Urgent Care: “Reinforce 111 capacity and support necessary ambulance services ‘see and treat’ and ‘hear and treat’ models as well as introduce secondary care dispositions (hot frailty services, speciality clinic, and same-day emergency care) allowing patients to avoid the emergency department if it’s clinically okay.

Cancer: “Cancer alliances and local systems need to identify ring-faced surgical and diagnostic capacity for the disease. In order to keep cancer surgery centres fully operational, providers must deliver and protect cancer treatment and surgery”.

Mental Health: “Establish open accesses crisis services and their helplines for all ages and promote those on local level by partnering with local authorities, community sector, voluntary and 111 services”.

The NHS must make most of “this opportunity to ‘lock in’ useful changes resulting from our collective effort in recent weeks”, said the guidance.

“This includes supporting local effort and flexibility, improved local system functioning,  sound clinical leadership, remote and flexible working where necessary, and fast emergence of the latest technology-empowered service providing options – for example, digital consultations”. 

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