Report: Recovery position: what next for the NHS?

This report, based on the first full survey of NHS trust leaders since Covid-19 started, sets out the scale of increased demand and the dramatic loss of capacity many trusts are now facing as the NHS juggles treating Covid-19 patients with restarting the full range of services. The report shows that, while trusts are restoring services as fast as they can, some trusts – particularly acute hospitals –  believe this restoration will take more than six months.


The NHS entered the COVID-19 pandemic with 100,000 vacancies (NHS Digital, 2020), A&E performance at an all-time low (NHS England, 2020a), a growing waiting list for elective care (NHS England, 2020b), increasing demand for mental health, community and ambulance services, and a social care system in a fragile state. This makes the achievements trusts, and their local system partners, have delivered to transform care within the first weeks of the coronavirus outbreak all the more remarkable. From creating sufficient critical care capacity to avoid the service being overwhelmed, to implementing community ‘discharge to assess’ models, accelerating the use of digital technology and creating ‘mental health A&Es’ to support those in need, their achievements are significant.

However, we all recognise that the priority to protect the public from COVID-19 came at the cost of suspending some services in the early weeks of the outbreak and delivering others in a different way. Trusts are now seeking to restart more services and exploring how they will balance the competing demands of retaining capacity to treat COVID-19 patients, cater for unknown future waves of the outbreak, and restart services in a way which keeps both their staff and patients safe.

This briefing shares the results of the first NHS Providers survey carried out with the chairsand chief executives of trusts since the COVID-19 pandemic began. It offers a snapshot view of the sector’s position as trusts emerge from the first peak of the outbreak, and move towards a ‘new normal’. It shares the different approaches trusts have put in place to continue caring for non-COVID patients, highlights the work they are doing to return to a sustainable level of services, and demonstrates the complexity of calculating what a sustainable level of service provision should be.

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