NHS at risk of slower path to coronavirus recovery

The Nuffield Trust has warned that the NHS is at risk of a slower and more fraught path to recovery than most comparable international systems due to its starting position going into the coronavirus pandemic.

The think tank compares measures taken by the NHS in England against health systems in 31 countries in response to coronavirus and examines the starting position of those countries’ health systems in terms of staffing, hospital beds and money for equipment and buildings.

The resulting report finds that many of the tactics taken by the NHS in England to reshape services, build extra hospital capacity, bring back recently retired staff and strike deals with the private sector have been mirrored in other countries. Equally, every country in the study cancelled or delayed non-urgent or elective procedures to free up more capacity for coronavirus patients and a majority created designated coronavirus hospitals or treatment centres.

However, the UK as a whole went into the pandemic with fewer doctors, nurses and hospital beds per person, lower levels of spending on buildings and equipment, and higher levels of hospital bed occupancy. In combination with the UK’s more severe outbreak, this means the NHS may face a tougher recovery than health systems across the countries analysed.

The analysis shows that the NHS ranks in the bottom third of 31 comparable countries when it comes to four of the six measures of healthcare capacity: capital spending, doctors per person, hospital beds per person and acute bed occupancy. While the UK ranks among the average for waiting times of the health systems analysed, its position is likely to deteriorate given that many parts of the NHS are working with outdated buildings and chronic workforce shortages. Warnings ahem already been made that outdated NHS buildings and properties will mean that reconfiguring facilities to support social distancing measures or virus-free zones will be more difficult.

The Nuffield Trust also claims that the UK entered the period with stark socioeconomic and racial inequalities relative to other countries, which may have made the virus deadlier and multiplied its spread. The UK’s outbreak was also more spread out, with London seeing 17 per cent of total cases in the country compared to 69 per cent of Finland’s cases in the Helsinki region and 60 per cent of Portugal’s cases in the Porto region.

Furthermore, low bed numbers and high occupancy rates within the NHS mean it has had less flexibility than other health systems to deal with the immediate surge of demand. Germany had over three times the hospital beds and nearly twice as many nurses per person than the UK.

Sarah Reed, the author of the report, said: “Covid-19 has tested the resilience of even the most well-prepared health systems, but the NHS’s relatively poor starting position when it comes to beds, staffing and spend on buildings and equipment is likely to make the path to recovery long and fraught.

“The NHS and its staff pulled out all the stops to react to the pandemic with impressive speed and resilience, avoiding the harrowing scenes in hospitals seen in other countries. But in the face of our devastating outbreak, the longstanding issues with bed capacity and workforce shortages that have been with us long before Covid-19 will continue to slow the health service down compared to other systems in the race to recovery. Looking ahead, this will mean longer waits for treatment, further rationing of care and the danger that health outcomes in the UK, which already lag behind many other similar countries, will worsen.”