We are still some way off knowing the full impact of the Covid-19 pandemic, but it is clear that it has required massive trade-offs that will have lasting consequences for the health and care system.
As in many countries, the NHS cancelled all non-urgent, planned surgeries to free up capacity for patients with the virus, contributing to a mounting backlog of health issues that the service will have to address in the pandemic’s wake. But while the government hastily made clear that ‘the NHS is open’ and essential and urgent services must continue, we have seen signs that demand has been suppressed as more patients are now reluctant to go to hospital, or have had their care cancelled as resources are redirected towards Covid-19.
As the UK resumes elective care, this briefing uses data and resources from the WHO, the European Commission, the European Observatory on Health Systems and Policies, and the OECD to understand how other countries are handling these issues and what the implications might be for the NHS.
It finds that:
- Countries around the world have used a range of common strategies to rapidly enlist staff, partner with the private sector, create field hospitals and convert health care spaces to build surge capacity and safely resume services. Covid-19 has required all health systems to make choices about how to prioritise care, manage infection control and maintain reserve capacity for future outbreaks.
- While the NHS has implemented similar strategies to many other countries, it is likely to have a slower path to recovery: the UK went into the pandemic with higher occupancy rates and fewer doctors, nurses and capital assets than most other health systems, while also being more severely impacted by the virus than most. Other things being equal, health systems with fewer resources and less slack will be more stretched in their efforts to recover care for those needing it.
- This has serious implications for waiting times in the UK. Resuming care during the pandemic introduces a number of logistical hurdles that will severely limit the ability of the NHS to deliver what it could previously. 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health systems analysed, its position is likely to deteriorate given that many parts of the NHS will be working with an outdated estate and chronic staff shortages to deliver health care with stricter infection control measures.
- Covid-19 has also exposed further vulnerabilities that will have lasting consequences for system recovery. The UK entered the crisis with stark socioeconomic and racial inequalities relative to other countries, which may make the virus deadlier and multiply its spread. Covid-19 has disproportionately impacted deprived communities and Black, Asian and minority ethnic groups. These inequalities are at risk of becoming more entrenched given the economic measures that have gone into containing the virus.
- While the trajectory of the NHS’s recovery will be determined heavily by its position at the start of the pandemic, it is not set in stone. There is now an opportunity to learn from and sustain positive changes the service has made in response to the pandemic and for government to work across sectors to redress the inequalities that threaten system recovery and sustainability.
Reed S (2020) Resuming health services during the Covid-19 pandemic: What can the NHS learn from other countries? Briefing, Nuffield Trust.