Healthcare Systems “Close to Collapse” Inquiry Finds
The Chair of the UK Covid-19 Inquiry, Baroness Heather Hallett, has published her third report which concludes that the UK’s healthcare systems “came close to collapse”. Ultimately it “coped, but only just”.
Module 3, the third of the Inquiry’s 10 investigations, has examined the impact of Covid-19 on healthcare systems across the four nations. It investigated how governments and society responded to the pandemic, the capacity of healthcare systems to adapt and the impact on patients, their loved ones and healthcare workers.
Thes new report published March 19, ‘The impact of the Covid-19 pandemic on healthcare systems of the United Kingdom’ (Module 3), finds that the UK entered the pandemic ill-prepared.
Healthcare systems were already overstretched and in a precarious state. This fragility had profound consequences once the crisis hit, especially when the numbers of people seeking treatment for Covid-19 started to increase dramatically.
Healthcare systems were overwhelmed and came close to collapse. Despite the best efforts of healthcare workers, many Covid patients did not receive the care they would otherwise receive and non Covid patients had their diagnoses and treatment delayed.
For some this meant their condition became inoperable. Healthcare workers put their lives at risk and the pandemic had a significant and long-lasting impact on their mental health and wellbeing.
In hospitals, visiting restrictions meant some vulnerable patients were left without vital support. Some people died alone. This continues to have a devastating impact on the bereaved.
Baroness Hallett has called for the prompt and thorough implementation of 10 key recommendations, necessary to prevent healthcare systems being overwhelmed in the next pandemic.
“This third UK Covid-19 Inquiry report concerns the impact of the pandemic on the UK’s healthcare systems. I can summarise that impact as: we coped, but only just.
“The healthcare systems came close to collapse. Healthcare workers carried the burden of caring for the sick in unprecedented numbers. It came at a huge cost to them, their families, their patients and the loved ones of patients. Collapse was only narrowly avoided thanks to the extraordinary efforts of all those working in healthcare across the UK.
“Despite those efforts, some patients did not get the level of care they would usually receive. The enormous strain placed upon the healthcare systems was unprecedented. “Those working within it were obliged to work under intolerable pressure for months on end.
We cannot know when, but there will be another pandemic. My recommendations, taken as a whole, should mean that the UK is better prepared for that pandemic. In doing so, we shall avoid some of the terrible human cost of Covid-19.
“I urge governments across the UK to work individually and collectively to implement these recommendations, in full and in a timely manner.” Baroness Hallett said.
Some of Baroness Hallett’s conclusions are as follows:
• While health ministers maintained that the UK never reached a state of overwhelm, “there was clearly overwhelm”. Lower levels of care were provided to patients and patients did not always get the care they needed, notwithstanding the efforts of healthcare workers.
• The pressure was, at times, intolerable and this continued for wave after wave of the virus. Healthcare systems entered the pandemic with low numbers of hospital beds, high bed occupancy, high numbers of staff vacancies and of sickness absences, meaning systems were in a precarious position from the outset.
• Initial infection prevention and control guidance was flawed because it assumed that Covid-19 was spread by contact transmission and failed to consider the extent to which the virus was also spread by aerosol transmission.
• Supplies of Personal Protective Equipment (PPE) were particularly constrained at the start of the pandemic, causing healthcare workers sometimes to work in inadequate and unsuitable PPE and put themselves and their families at risk to care for patients.
• 111 services were not able to cope with the level of demand. Call demand for advice and information about Covid-19 increased dramatically, particularly in the early stages of the pandemic.
• Waiting times for emergency ambulances grew. Waiting times for even the most life-threatening calls grew, with some ambulance services resorting to military aid to ensure there was not a significant risk to life.
• Visiting restrictions meant that many patients died without the comfort of being surrounded by their loved ones, while vulnerable patients such as those with dementia or a learning disability and children in mental health inpatient units, as well as women accessing maternity services were left without vital support.
• The public messaging “Stay Home, Protect the NHS, Save Lives” may have, inadvertently, sent the message that healthcare was closed, contributing to a decline in attendances even for life-threatening emergencies such as heart attacks.
• The mental health of healthcare staff was severely impacted, with many exhibiting signs of post-traumatic stress disorder, while burn-out was common
Hugh Alderwick, Director of Policy and Research at the Health Foundation, said:
‘Module 3 of the COVID 19 Inquiry highlights how the UK’s health services lacked the resilience to respond to a global pandemic. The NHS entered the pandemic in a weak position, held back by long-standing gaps in health care capacity, chronic staff shortages, years of underinvestment, and limited action to address deep rooted health inequalities.
‘These policy failings led to real harm. Some patients went without the care they needed. Others saw vital care delayed. And staff faced relentless pressure delivering care in the face of widespread suffering.
“The NHS is still living with the consequences. While we’ve seen improvements in some areas, the underlying challenges facing the health service have not disappeared, including long waits for planned hospital care, unacceptable delays in urgent and emergency care, and staff feeling burnt out and lacking the resources to deliver high-quality care.
‘The challenge for policymakers today is how to ensure that the UK’s health and care system is better placed to manage future emergencies. Priorities now are eerily similar to before the pandemic – boosting health system capacity, reforming and investing in adult social care, putting in place high quality data and analysis, better supporting staff to deliver high quality care, and more.
“The Labour government has set out ambitious plans to reform the NHS in England, but resources to deliver them are constrained and short-term pressures risk crowding out the long-term action needed to boost and redesign services outside hospitals.
‘Policymakers must also recognise that resilience against future health threats rests on a healthier population, not just a stronger health care system. Cross-government action is desperately needed to improve health and reduce health inequalities across the UK, including on housing, employment, social security, and other factors that shape our health.’
