NHS trusts may be forced to cancel appointments and limit visiting times in a Covid and flu “twindemic” this winter, health leaders have warned.
Fears have been raised the viruses could strip back the workforce and further increase demand for services during an already busy period.
It comes amid rising Covid infections in the UK. Around 1.3 million tested positive in late September, according to the latest figures, which was a 25 per cent increase on the week before.
The UK is also concerned there could be a bad flu season this year, with lower immunity across the population due to reduced exposure in the Covid pandemic.
NHS leaders have warned that this background could make winter even more difficult for the health service.
“I make no bones about this: we know it’s going to be a pressurised time for trusts over the next four months if not longer,” Saffron Cordery from NHS Providers, which represents trusts in England, told The Independent.
The interim chief executive added: “We’re worried about Covid and we’re worried about flu.”
Ms Cordery said these joint pressures – which could increase demand, strip back workforces and introduce the need for greater infection control measures – could have a knock-on effect on services.
“We need to anticipate that there may well be cancellations for either outpatient appointments or routine procedures or operations, because there could be staff shortages or rising demand in emergency care – that means that those routine appointments cannot take place as quickly as we’d like,” she said.
Winter pressures could also lead to increased waiting times at A&E and for ambulances, she said. “That’s one of the enduring pressures we’ve seen over the last few months. And we know that that isn’t a good experience for patients or their families. Indeed, it’s very worrying and also very challenging for staff.”
Ms Cordery added: “We may also once again face difficult situations where visiting times will be restricted in some areas because the risk of passing on Covid to vulnerable patients is too great. “
Universal mask-wearing could also return to protect vulnerable patients and staff. “It may well be that that is the price we have to pay in order to continue with services,” Ms Cordery said.
A hospital ward in Hereford reportedly closed down due to a Covid outbreak on the same day a 25 per cent rise in cases across the country was reported.
Dr Layla McCay from NHS Confederation, which represents the healthcare system in England, said: “With huge staff vacancies and an elective care backlog which now stands at nearly seven million patients, the NHS is facing the most challenging winter on record.
“Health leaders around the country are very concerned by the rising rates of Covid and flu as well as the severe pressures the costs of living crisis is having on people’s physical and mental health.”
She added: “The government must now be honest with the public about the service they can expect in the months ahead.”
The NHS has already pledged to create thousands more beds and recruit more emergency call handlers to cope with demand expected this winter.
But charities said they were “really worried” for patients this year – especially as the cost of living crisis bites.
Ruthe Isden from the Richmond Group of Charities, which includes Age UK, Macmillan Cancer Support and the British Heart Foundation, said demand for the NHS was increasing as people were generally suffering from more ill health after the Covid pandemic.
“We know that the NHS, such systems are already struggling to meet that need, particularly around GP services. And that position is not going to get any better as we head into winter. We only see these will grow, as the cost of living has an impact on people’s health.”
She said charities were already hearing people skipping paid prescriptions and not being able to afford running medical equipment or fridges to keep insulin at home.
“We’re hitting the crunch, really, where we have a growing number of people who need help for all sorts of reasons, coming off the back of the pandemic, because of Covid itself, because of the cost of living. And we have a smaller number of people working in the health and social care systems provide it.”
Official data estimates there are 132,000 vacancies across trusts in England. Leaders have previously warned the cost of living crisis was also forcing healthcare workers to quit in pursuit of better-paid jobs.
Christina Pagel, a healthcare expert from Independent Sage, agrees: “The cost of living is going to incentivise even more people to leave, particularly for low-income healthcare workers. And it’s not just nurses as cleaners, it’s porters, that people who actually have a really crucial role.”
She added: “I think it’s going to be a terrible winter, I think there’s nothing to make you hopeful about this winter for the NHS. The NHS has effectively been in crisis mode for a year.”
NHS medical director, Professor Sir Stephen Powis, said: “The threat of a Covid-19 and flu season creating a “twindemic” this winter is real, as infections levels continue to rise and the number of people in hospital with covid climbing by more than a third in just over a month across England.
He urged anyone eligible for a Covid autumn booster to take up the officer. “The vaccine remains the best protection against serious illness and hospitalisation from covid this winter.”
The NHS will remind more than 6 million people who are at risk or over 65 who are yet to get boosted this autumn to book a jab next week.
A Department of Health and Social Care spokesperson said: “We are putting a laser-like focus on the issues that affect patients most: Ambulances, Backlogs, Care, Doctors and Dentists – and last month the Health and Social Care Secretary set out a Plan for Patients to improve NHS care over this winter and next.
“As part of it, we will invest an additional £500 million funding in adult social care to speed up hospital discharge and support the social care workforce, freeing up beds for the patients that need them.”
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