1/17 Today, we're launching results of first major survey of NHS trust leaders since covid-19 started. The report - "Recovery Position, What Next for the NHS" looks at challenges facing NHS to treat covid 19 patients and restart services. Report here: https://nhsproviders.org/media/689775/recovery-position-what-next-for-the-nhs.pdf

2/17 You can find the press release (good summary) of our new report on the challenges facing the NHS as it restarts services here: https://nhsproviders.org/news-blogs/news/nhs-recovery-position-much-greater-realism-and-more-government-support-needed. Linked blog can be found here: https://nhsproviders.org/news-blogs/blogs/nhs-recovery-position-a-tough-but-clear-sighted-prognosis/.

3/17 Four key messages from first member survey post covid-19: lot more patients now needing treatment; trusts losing lot of capacity due to covid-19 (up to 40%); trusts going as fast as they can to restart services; but it will take some time to resume full range of services.

4/17 Message 1. Trusts are facing significantly increased demand. 54% report increased demand for more urgent or crisis care and/or severe and late presentation. 80% report fewer non COVID patients sought care in the previous month [survey conducted 21 May – 31 May].

5/17 Message 1 (cont) 89% of trust leaders believe there is now an increased backlog of people waiting for care. And pre-covid, despite treating record patient numbers, trusts already struggling to keep up - lowest performance against urgent and elective care targets in a decade.

6/17 Message 2. Trusts facing major capacity constraints and uncertainties in trying to restart services. Trusts needing to treat covid-19 patients, keep surge capacity and ensure effective infection control all having a major impact in reducing available capacity.

7/17 Message 2 (cont) 92% of trust leaders believe physical and social distancing reduces available capacity. 92% are concerned about staff wellbeing, stress and burnout following the pandemic. 80% believe there is an unpredictable level of COVID-19 demand.

8/17 Message 2 (cont) 57% believe there is insufficient testing capacity and 53% insufficient PPE supply to fully restart services. Trusts estimate they're currently running at c50% capacity for non-COVID services with capacity rising to 70% in 3 months, and 80% in 6 to 12 months

9/17 Message 3. Trusts are doing all they can to restart services as quickly as possible. 86% have increased capacity for remote services like video consultations. 78% have reconfigured their workforce to speed up the resumption of services.

10/17 Message 3 (cont) 57% of trusts are using independent sector capacity to increase the flow of patient treatment. 46% of trusts said in our survey that they have formed new partnerships with other trusts to maximise available treatment capacity. Lots of work going on at pace!

11/17 Message 4. Combination of significantly increased demand and significantly reduced capacity means services will take significant time to resume, particularly in acute hospitals. Only 7% say they are immediately ready to meet the needs of all patients and service users.

12/17 Message 4 (cont) 22% of trusts say it'll take 3 to 6 months to be ready to meet needs of all patients/service users.14% say it will take them 6 to 12 months to be in that position. It will take a lot longer than may think to restart all services, let alone tackle backlogs.

13/17 Message 4 (cont) Clear difference between mental health (82%), ambulance (80%) and community (67%) trusts’ readiness to resume services within six months vs hospital trusts (39%). Every hospital trust we talk to says they lose c20-40% capacity whilst covid-19 with us.

14/17 What does our survey mean? Three thoughts 1. NHS faces really difficult problem. Our survey shows that the NHS will simply not be able to do all that is currently required of it. We must therefore have an honest and difficult debate about priorities.

15/17 2. Berating trusts for not going faster won’t help. Trust leaders are as frustrated as patients and service users they can’t go faster. They will bring the same commitment, pace and problem-solving ingenuity to this task that they demonstrated in the first peak.

16/17 3. Government must recognise NHS needs more capacity to offset lost capacity. Key decision to make on keeping independent sector beds / Nightingale hospitals and funding extra capacity needed in community, mental health, general and acute beds and emergency departments.

17/17 Summary: More people to treat. A lot less capacity availabe in NHS whilst covid-19 is with us. Trusts going as fast as they can and working as hard as they can, as they did in first peak. But we must be realistic about how much the NHS can deliver within these constraints.