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BLOG: We need more testing and greater flexibility for hospitals to combat the new wave of COVID-19

04 Nov 2020

“We need a strategy to help us through the next few months. First and foremost we need to reduce community transmission by whatever means work best and a collective societal contract to follow guidance. Next, there will have to be some flexibility in the balance of acute COVID-19 work, non COVID-19 acute work and elective work. The balance of activity will vary for different areas of the country: one size will not fit all, but health boards and trusts need to be given “permission” to reduce elective activity where necessary.”

In her latest guest blog, College President Professor Jackie Taylor sets out her concerns on how the NHS is operating during this second wave of COVID-19.

This weekend the UK has been felt the full force of Storm Aidan. The NHS has also been facing stormy conditions of its own: a rapidly rising second wave of COVID-19 cases, a desperate desire to maintain some semblance of “business as usual”, an exhausted workforce and a long winter ahead.

Many hospitals are already caring for more patients with COVID-19 now, than in the first wave, and some are already on the brink of saturation of services.

Back in March as healthcare professionals rallied to the call, and headroom was created by a temporarily suspending elective work, there was a real sense of keeping the NHS afloat, and navigating it through troubled waters to calmer seas. That we did, and then all hands were on deck to do our utmost to play catch up, reduce our backlog of outpatient appointments and procedures and ensure that we absolutely minimised any non COVID-19 harms.

While there is great geographical variation, where prevalence and hospitalisations are high, many colleagues now feel as though they are in the eye of the storm, and that this will ebb and flow all winter. Now the hands are all back on deck, but there are fewer of them, due to sickness, and many of those able to work are struggling with fatigue, low morale and a sense of despondence.

There are many positives which it helps to keep our weather eye on: we do have a far better understanding of the virus and how it impacts on populations, we have some treatments, and there is the hope of vaccines on the horizon.

We need a strategy to help us through the next few months. First and foremost we need to reduce community transmission by whatever means work best and a collective societal contract to follow guidance. Next, there will have to be some flexibility in the balance of acute COVID-19 work, non COVID-19 acute work and elective work. The balance of activity will vary for different areas of the country: one size will not fit all, but health boards and trusts need to be given “permission” to reduce elective activity where necessary. It isn’t a case of COVID-19 versus non COVID-19: unless we manage COVID-19 effectively we will not be able to provide essential and elective care.

We urgently need a testing strategy for the public, but a priority is the testing strategy for healthcare staff, and the capacity to deliver it in an efficient and timely manner. And we need clear messaging to the public to explain that in some areas the NHS is facing extreme pressures. Patients who are ill will never be turned away but we need people to understand the whole range of healthcare services which they have access to and help them to access the right service at the right time.

So it is definitely not time to abandon ship or to sink or swim, but to all keep pulling in the same direction.

We need an urgent strategy and are pressing for this through the Scottish Academy.


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