Austerity left NHS in 'precarious position'
The long-awaited report into the impact the Covid pandemic had on the NHS has been published. It reveals that the NHS in England came close to collapse during the height of the pandemic, narrowly avoiding it due to the extraordinary efforts of healthcare staff.
In the decade before the pandemic, the NHS experienced historic budget constraints. Although spending increased slightly, it did not keep pace with the rapidly rising demand driven by an ageing population and more people living with long-term health conditions.
The report states this left the NHS entering the pandemic in a "precarious position" with insufficient beds and staff. This shortage meant the NHS struggled to manage the surge in Covid patients, particularly during the first wave, with oxygen supplies nearly depleted in some areas.
As the pandemic continued, the NHS became overwhelmed, and patients did not always receive the care they required. The pressure was described as intolerable at times and persisted through successive Covid waves.
Ambulance waiting times increased, even for the most critical calls, prompting some services to enlist military assistance. Intensive care staffing ratios were reduced, shifting from one nurse per patient to as many as one nurse per four patients.
The report concludes that a collapse of the NHS was only narrowly avoided due to the exceptional dedication of its staff.
Long delays and lack of capacity
The inquiry highlights failures affecting both Covid patients and those needing treatment for other conditions. It notes significant delays for Covid patients accessing NHS services and waiting for ambulances. Some seriously ill patients could not be admitted to intensive care due to capacity shortages.
Disruptions to cancer screening and a decline in people presenting with symptoms led to missed and delayed diagnoses, resulting in loss of life. The cancellation of non-urgent procedures, such as knee and hip replacements, had a "debilitating effect" on patients' mobility and quality of life.
Stay at home slogan gave impression NHS was closed
The report criticises the government's "Stay Home, Protect the NHS, Save Lives" messaging. While intended to prevent overwhelming the healthcare system, it inadvertently suggested that NHS services were closed.
This is supported by a decline in A&E attendances and visits for non-Covid emergencies, including heart attacks. The report states that people were deterred from seeking care because they did not want to burden the NHS.
Lack of support and rules too tough
The report addresses the controversial hospital visiting restrictions during lockdown. It states these rules meant some patients died without loved ones present, leaving bereaved families feeling "heartbroken, guilty and angry".
Vulnerable patients, including women giving birth and people with disabilities, lacked essential support. The report recommends avoiding such strict rules where possible.
Visiting restrictions had a "devastating impact" on bereaved family members and mothers receiving difficult pregnancy news alone. The rules were sometimes applied inconsistently, causing feelings of unfair treatment when visits were denied.
Shielding vulnerable patients led to loneliness and social isolation, underscoring the need for better planning to mitigate such effects in future pandemics.
The report also notes that inappropriate do not resuscitate orders were imposed on groups including people with learning disabilities and older adults.
Shortages meant staff worked in 'inadequate' conditions
The experience of NHS staff is examined, highlighting shortages of personal protective equipment (PPE) and the pandemic's mental health impact.
Shortages of masks, gloves, and gowns forced healthcare workers to operate in "inadequate" conditions that increased their risk. PPE supplies reached "dangerously low" levels, with the NHS reportedly just days away from running out of key items at one point.
There was a lack of specialist masks that fit tightly for certain face shapes, affecting ethnic minority and female staff.
The report finds that early infection control guidance was "flawed," failing to acknowledge airborne transmission via aerosols that remain suspended in the air.
Some health workers developed post-traumatic stress disorder after working in what were described as "war zones," and burnout was widespread.
