It has taken us over a year to win disclosure of these secret documents prepared by NHS England for the Department of Health & Social Care in 2017/18. They address a pandemic influenza but they are clearly relevant for UK pandemic management during COVID-19. Both documents will be published and downloadable here from 9am on 31st July 2021.
The Telegraph’s Investigations Team have published a front page exclusive story on the two pandemic documents.
NHS England have issued a statement to the Telegraph: “The NHS was asked to produced this discussion document based on a specific and extreme hypothetical scenario to inform the Government’s pandemic flu preparedness programme rather than for operational use and it did not form the basis of the NHS response to coronavirus.”
If these documents did not form the basis of the NHS response to coronavirus, then what triage plan did NHS England prepare for coronavirus and why have they consistently refused to share it with frontline NHS staff who have had to make very challenging decisions on the ground?
We encourage everybody to read the documents and make your own minds up.
NHS Surge and Triage document
- The UK’s relatively modest intensive care capacity is recognised, and short-term emergency measures are considered to increase this, but NHS England makes no mention about a long-term plan to build pandemic resilience.
- The decision to move to triage would happen when 6,500 out of a projected emergency 7,000 ICU beds were occupied.
- Patients to be assessed on probability of survival rather than clinical need.
- Age and “life years saved” would be important in allocating care, for instance the document says “perinatal/maternal care plus childhood care being protected would have the greatest benefit”.
- The document has an Annex which provides extremely useful guidance and specific clinical examples for healthcare professionals on the ground in a severe pandemic.
- The document was discussed with the British Medical Association and Academy of Royal Sciences, and was planned for discussion with the Presidents of the Royal Societies, regulators and professional bodies. It was never discussed with the frontline NHS staff who would have to make these difficult decisions on the ground.
Adult Social Care document
- The “vast majority” of UK adult social care is provided by independent private providers, and 91% of the workforce work in the independent sector.
- There are 90,000 vacancies in the care sector, with high tunrnover rates of registered nurses and care workers.
- There are significant gaps in the Government’s data on social care. They do not know how many beds are occupied. There is no national data which breaks down domiciliary care provided at home. Regarding the lack of data on community health services, the report says “this data set is not suitable to model how a reasonable worst-case scenario pandemic will impact community healthcare demand”.
- The document plans to use social care for “rapid discharge from hospital to maximise hospital capacity”, which we know happened during the first wave of COVID-19 with disastrous consequences. The social care document also plans to increase capacity in residential / care homes by installing extra beds in rooms. The document seems to make no allowance for risks of increased infectivity within care homes.
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