Will the government’s Autumn and Winter Plan do enough to protect the NHS?

The government has unveiled its Autumn and Winter Plan which details how it will tackle the Covid-19 pandemic heading into the coming months.

The primary aim of ‘Plan A’ is to “sustain the progress made and prepare the country for future challenges, while ensuring the NHS does not come under unsustainable pressure.”

To achieve this, the government says that the NHS will begin to offer priority groups 1-9 a booster vaccine from next week. The announcement comes following advice published by the Joint Committee on Vaccination and Immunisation (JCVI) yesterday (14th September).

Booster jabs will be available to all those aged 50 years or over, those aged 16 to 49 with underlying health conditions, those who are contacts of immunosuppressed individuals, and frontline health and social care workers. A third dose will be given no earlier than six months after completion of the primary vaccine course.

Professor Wei Shen Lim, Chairman of the JCVI, highlighted that the advice does not imply that there will be a recurrent programme of booster doses every six months, and this advice is only relevant to protect us from the coming winter while we are still in an active stage of the pandemic.

Alongside the booster programme, the government will also be offering 12-15 years old their first dose of the jab and encouraging those who are not yet vaccinated to come forward.

They government says it will also continue to offer free PCR and lateral flow tests, support the NHS financially and provide guidance and communication to the public.

Ministers hope this will be enough to reduce the number of Covid-19 infections, hospitalisations and deaths therefore preventing the NHS from coming under unsustainable pressure.

Plan B could be introduced if the NHS comes under “unsustainable pressure”

The Health Secretary, Sajid Javid, told the House of Commons that if Plan A is not effective and the NHS starts to struggle, ‘Plan B’ will come into play.

Plan B will see certain restrictions reintroduced, including: communicating caution to the public, legally mandating face coverings in certain settings, and asking people to work from home where they can.

Javid said that while the government will not be imposing mandatory vaccine certification (or vaccine passports) at the moment, they will hold that power in reserve.

It is not yet clear exactly what the criteria is for moving the country to Plan B, although scientists believe that the number of people in hospital will be key.

Currently, 7% of hospital beds are filled by Covid patients, and although this may not sound like a lot, hospitals are already running close to capacity and so any extra cases will quickly have an impact on other care that can be provided.

Flu and other respiratory viruses “highly likely to make their returns” this winter

Professor Jonathan Van-Tam, deputy chief medical officer for England, said that while the UK has had one of the most successful Covid-19 vaccination programmes in the world, it is essential that we “stay on top of things” and avoid overloading the health service.

He warned that the pandemic is still active and that this winter “could be bumpy at times” with flu and Respiratory Syncytial Virus (RSV) “highly likely to make their returns”.

He also confirmed that it is safe for the flu vaccine to be administered at the same time as the Covid vaccine and this will likely be rolled out alongside the booster programme immediately – as long as supply allows.

England’s chief medical officer, professor Chris Whitty, similarly stressed the importance of taking up the flu jab: “People still need to take this disease very seriously. I don’t think you need a medical degree to know that autumn and winter is when respiratory viruses are hugely advantaged, as people come together indoors with their windows closed and so on,” he said.

Will these measures go far enough?

Professor Whitty further warned that we are heading into the coming months at much higher levels of Covid infection and hospitalisation compared to this time last year.

Many healthcare professionals are therefore concerned that the government’s Autumn and Winter Plan will not go far enough to protect the NHS.

Dr Chaand Nagpaul, BMA council chair said if other measures are not introduced soon, we will struggle to “keep the health service afloat this winter”.

He continued: “The UK Government introduced restrictions last October because it was rightly worried that there were more than 1,000 Covid patients in hospital – today we have more than 8,000 hospitalised Covid patients and 50% more patients in ITU.”

Dr Nagpaul says that tougher restrictions, such as making masks a requirement, should therefore be implemented before it is too late.

“If left too late, we could find ourselves in a position where the NHS is dangerously overwhelmed, returning to a situation where ambulances were queueing round corners and hospitals had no choice but to pause all elective care, further increasing the already enormous backlog,” he added.

This comes as research by the BMA suggests that the NHS is currently 50,000 doctors short of where it needs to be, with this number steadily increasing.

As staff continue to exhaust themselves trying to keep up with patient demand, many are suffering from burnout and leaving the NHS altogether to get the respite they need.

If this continues, experts warn that the workforce crisis will only worsen, stretching the health service to its limits.

The BMA are therefore calling on the government to invest an extra £10 billion in funding to reduce the ongoing pressures on staff and to retain and recruit more healthcare professionals, as well as the implementation of firmer, more restrictive measures in order to cope with the pressures expected in the upcoming months.