Covid-19 deaths and infection rates continue to drop in most parts of the world, yet this is far from the end of the pandemic.
The World Health Organization has said the virus is not under control and infections are accelerating. We are now embarking on a new phase of planning and modelling that will determine how our health systems need to work in the future.
Amid fears that the UK is heading for a second peak and the need forpreparedness, NHS health systems are working hard - both to provide safe care to tackle ever-increasing waiting lists for postponed elective surgery and to ensure sufficient capacity to deal with a future rise in Covid-19 cases. The full impact of postponing elective surgery is yet to be discovered, but the British Medical Association has warned patients are being neglected and illnesses are worsening.
An unknown future means the need for a new way of ensuring capacity
Capacity has been a thorny issue for the NHS for decades. Many trusts have been running at near full capacity for years (92-95 per cent) and have become very good at managing this by looking in the ‘rear view mirror’ to benchmark themselves against peers.
This approach works well because it means you can look backwards to predict what is likely to happen in the future and is particularly helpful when you consider future predictions about health service demand. For example, all NHS Trusts are likely to have believed in January that they had the correct number of critical care beds for their needs.
However, running at such a high capacity means there is little flex in the system when a pandemic hits. Resources can be switched but there is no room for manoeuvre in terms of overall capacity.
The ability to expand and contract capacity is vital and going forwards we need to be in a better position to do this as it is inevitable that another pandemic or other disruption will be just around the corner.
Pandemic data can help to establish a nationwide baseline of activity
To enable better understanding of what happened within the health system, it is necessary to analyse the data captured by NHS organisations from the early months of the pandemic. The Health Episodes Statistics (HES) data for the pandemic period will soon be made available from the NHS and other healthcare organisations, and will enable a nationwide baseline across all areas of activity, giving a better understanding of the capacity needed to expand and contract.
The chart below is based on data from 29 CHKS clients across England, Wales and Northern Ireland to end April 2020. It shows average numbers of episodes of care split into broad types, per calendar day in a month – with normal seasonal variations in 2019, but a general consistent spilt and total volume.