Extreme caution needed in reviewing tier systems

NHS Providers has written to the Prime Minister ahead of a review of coronavirus restrictions on 16 December, urging extreme caution over relaxing the rules.

In a letter to Boris Johnson, the organisation which represents every hospital, community, mental health and ambulance trust in England, draws on the latest evidence and conversations with trust leaders, and highlights a ‘worrying increase’ in infections across a wide range of areas, with the overall trajectory over the last fortnight ‘at the bottom end of hopes and expectations’. Therefore, as well as urging extreme caution, the letter also requests that areas that should be in the highest Tier 3 category to be moved into that tier without delay.

Trust leaders are concerned that, unless rising rates come right down, the spread of the virus will quickly gather pace as soon as restrictions are relaxed, triggering a third wave of coronavirus patients coming into hospitals just as the NHS enters its traditional busiest period. This is exacerbated by current issues with hospital beds, with NHS Providers emphasising that the reduction in the number of coronavirus patients in hospital, post peak, is significantly slower than in the first wave and, in some areas, the number of coronavirus inpatients is increasing. This is at a time when enhanced infection control measures mean the NHS has 10,000 fewer beds in operation.

Although the letter stops short of arguing for a review of the proposed temporary relaxation of social contact rules over Christmas, it urges the Prime Minister to take a personal lead in ensuring a better public debate about the risks inherent in the guidance for 23 – 27 December.