Hospital admissions during first two months of lockdown in England

Sir Simon’s comments come as health leaders have warned the NHS is unable to return to full capacity because of the need to protect staff and patients from the risk of infection.

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Hospitals in England saw almost three-quarters of a million fewer patients admitted for treatments such as routine surgery during the height of the coronavirus outbreak, the head of the NHS has revealed.

Giving evidence to the House of Commons Health Select Committee on Tuesday, Sir Simon Stevens, chief executive of NHS England, said there were 725,000 fewer elective or planned admissions to hospitals during March and April.

Sir Simon said: “The number of elective admissions in March and April was around 725,000 lower than what we might have expected given pre-Covid levels of growth. The drop was greatest in April when we saw around 530,000 fewer elective episodes. That number has begun to recover quite significantly since then. As we speak, we think we’re now somewhere north of 55 per cent of pre-Covid elective activity levels.”

He said he hoped the NHS may bounce back to almost three-quarters of normal activity levels by July or August.

Elective or planned treatments in hospitals do not cover emergency admissions or where patients are admitted because of urgent treatment.

Some estimates suggest waiting lists for NHS surgery could rise to 10 million by the autumn.

On cancer services, Sir Simon told MPs: “We saw a much higher continuation of cancer care, including cancer surgery. During the March April period, although there was a drop off in referrals. We saw around 96 per cent of the usual treatment starts for cancer over that period.”

On the fear of rising waiting lists, Sir Simon said: “Contrary to some of the commentary, the waiting list will go down before it goes up, potentially significantly. The reason for that is that fewer people are coming forward and being referred onto a waiting list than was the case before. So actually we’ve seen the overall waiting list drop by over half a million people between February and April, but we expect that as referrals return that will go up quite significantly over the second half of the year.”

He said during the outbreak NHS hospitals in England had looked after more than 100,000 Covid-19 patients who needed treatment. Currently, he said around 3,000 patients were still in hospital with coronavirus.

Sir Simon said around four-fifths of patients on a waiting list were waiting for a test rather than a treatment such as surgery, and this will mean significant changes to diagnostic services: “We’ve got to do something different. We’ve got to expand diagnostic capacity. We’ve also got to do it in new ways and this will be particularly true for endoscopy… this will be very relevant for cancer care particularly bowel cancer services. And so we are looking for a radically different model of doing endoscopy investigations.”

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He said the NHS was now looking to run “dedicated diagnostic and endoscopy suites with three sessions a day” and using what he described as a “Nightingale-type approach for new diagnostic facilities”.

He said: “The first of those is going to be the Exeter Nightingale which we are going to partly repurpose for non-Covid CT scanning, that will begin next Monday and run eight till eight, seven days a week.”

Dr Andrew Goddard, president of the Royal College of Physicians, told MPs NHS staff were “exhausted” and he feared the impact of a second wave of the virus on the NHS that could make the task facing the health service even worse.

He warned almost 40 per cent of doctors did not believe they would be back to normal capacity to treat patients for 18 months or more.

Chris Hopson, chief executive of NHS Providers, which represents health trusts, told the committee hospital bosses wanted more clarity from NHS England on testing for NHS staff and he said 92 per cent of senior NHS managers were worried about “burnout” among the NHS workforce.

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