Health leaders are calling on the government to enact the Covid-19 ‘Plan B plus’ to avoid ‘stumbling into winter crisis’ where pressures on the NHS are deemed to be at risk of becoming unsustainable.

The NHS Confedation, an independent membership body for the full range of organisations that make up today's NHS, want certain measures to be introduced without delay to keep people well and avoid the NHS from becoming overwhelmed this winter.

This includes mandatory face coverings in crowded and enclosed spaces, clear communications to the public that the level of risk has increased, introducing certificates for people’s Covid-19 vaccine status, in addition to considering asking people to work from home if they can.

It says that increases in coronavirus cases in its hospitals and the community are 'worrying' at a time when it is preparing for a busy winter period, its staff are close to burnout, and it is being expected to recover many of its services that were disrupted by the pandemic.

Impact on people with a learning disability

The Covid-19 pandemic has already hit people with a learning disability hard. A new report last week flagged the disproportionately high mortality rates that people with learning disabilities and autistic people suffered from Covid-19.

It also reported that the lockdowns, and in particular, the loss of social support that came with them, were extremely damaging to the wellbeing of some people with learning disabilities.

Matthew Taylor, chief executive of the NHS Confederation, said: “The NHS is preparing for what could be the most challenging winter on record and it will do everything it can to make sure its services are not disrupted but these outside pressures are not solely within its gift to influence. As cases of coronavirus continue to climb, alongside other demands on the health service and pressure on staff capacity in both the NHS and social care, leaders are worried about what could be around the corner.

“There is a crucial opportunity for the public to pull together and show extra support for the NHS by behaving in ways that will keep themselves and others safe and also safeguard stretched frontline services for those most in need.

“It is time for the Government to enact Plan B of its strategy without delay because without preemptive action, we risk stumbling into a winter crisis. Also, health leaders need to understand what a ‘Plan C’ would entail if these measures are insufficient."

The government should not wait for Covid infections to rocket

The NHS Confederation added that government should not wait for Covid infections to rocket and for NHS pressures to be sky high before the panic alarm is sounded.

Last month, the government set out its Covid-19 winter strategy, which focused on building the population’s defenses through vaccinations and other pharmaceutical interventions, as well as test, trace and isolate measures, and public health messaging. Within that, a ‘Plan B’ would be enacted if pressures on the NHS were deemed to be at risk of becoming unsustainable. 

Many of these measures, particularly around mask-wearing and Covid-19 certification, are already common in parts of Europe where the prevalence of the disease is lower.

The membership body is calling for these actions to be introduced sooner rather than later so that if cases of coronavirus still rise to worrying levels, the government can then introduce tougher measures, if needed.

Alongside this, the NHS Confederation believes that this should go further with a ‘Plan B plus’, calling on the public to mobilise around the NHS and do whatever they can to support frontline services this winter. This could include by:

  • Getting vaccinated, including booster shots when invited.
  • Turning up for scheduled healthcare appointments on time.
  • Using frontline services responsibly, such as by only calling 999 in emergency situations and accepting appointments with primary care professionals other than GPs, such as practice nurses and community pharmacists, as well as remotely from both primary and secondary care, if offered and suitable
  • Volunteering to support the NHS and joining or returning to the workforce, if eligible. 

Current number of Covid-19 cases

Confirmed cases of coronavirus in the UK have exceeded 40,000 for the last seven days, with 43,738 recorded today (Tuesday) and 49,156 on Monday. The last time cases were in this bracket was in mid-July. Also, English hospitals have seen a 10% increase in Covid-19 cases in the last week, with 7,749 people reported at the last count. Deaths are averaging around 120 a day but today there were 223 deaths within 28 days of a confirmed positive diagnosis.

Vaccinations have played a significant role in keeping these numbers lower than they could have been and were in previous waves of the pandemic, with the NHS currently supporting booster shots and flu vaccinations to more patients than ever, as well as supporting Covid-19 jabs for 12- to 15-year-olds. Over 83 million jabs have been given in England so far.

The British Medical Council (BMA) agreed that ‘Plan B’ to prevent the NHS from being overwhelmed should be implemented immediately as we now have the same number of weekly Covid deaths as we had during March, when the country was in lockdown.

BMA council chair Dr Chaand Nagpaul said: “It is therefore incredibly concerning that he is not willing to take immediate action to save lives and to protect the NHS. Especially as we head into winter, when the NHS is in the grips of tackling the largest backlog of care, with an already depleted and exhausted workforce.

“The Government has taken its foot off the brake, giving the impression that the pandemic is behind us and that life has returned to normal. The reality today is an unacceptable rate of infections, hospitalisations and deaths, unheard of in similar European nations. In comparison to France, we have more than 10 times the number of cases and almost four times as many deaths per million.

“Only last week two select committees found the UK was an international outlier when it came to public health policy during this crisis. We are rapidly approaching a position where, yet again, the Government is delaying for too long, and equivocating over taking action. This is the time to learn the lessons of the past and act fast, or else we will face far more extreme measures later.”