Routine hospital care will be hit if NHS to meet booster deadline, health chiefs warn

Senior NHS leaders have warned the only way to hit the government’s booster vaccine deadline will be to reduce or cancel routine care, as they await direction on how to roll out the plan.

Speaking with The Independent, several NHS leaders have said it is inevitable that ramping up Covid-19 vaccination services to meet the government’s January deadline will draw healthcare staff away from non-urgent treatment.

Plans to invite all adults for a Covid-19 booster jab by the end of January were announced on Monday, however healthcare providers have yet to be told how the NHS is expected to ramp up the rate of vaccinations.

One NHS trust leader in the Midlands said reducing routine care will “absolutely be the only option” and added: “It’s the only way of hitting the deadline, we’ve done the modelling and [we] will need hundreds of additional whole time equivalent staff. The only way we will be able to meet the requirement will be to stop less essential and more routine work and I’m very reluctant to do that given the backlogs and pressures in the system.”

NHS waiting lists are already at record levels, with 5.8 million people in line for routine treatment. The National Audit Office predicted on Wednesday this could reach 12 million by 2025.

Ministers are reported to be discussing whether GPs can suspend work such as health checks and screening, which come under what is called the national “quality outcomes framework” contract. During 2020-21 this contract was suspended to help GPs deal with immediate pandemic pressures.

One local NHS leader said “Some of the screening and non-urgent GP work could be stood down and that is being negotiated nationally” but clarity would also be needed for community service providers, which have carried out much of the vaccine programme.

Speaking at a Downing Street press conference on Tuesday, NHS chief Amanda Pritchard said the expansion of the programme “cannot happen overnight” given the pressures facing NHS staff at the moment.

She added: “They are working hard to address the backlogs that have inevitably built up in less urgent care, while hospitals cared for more than half a million patients with Covid as inpatients and of course many, more in the community.”

The Independent was told by some leaders that while awaiting national guidance on what routine care can be dropped various systems were looking at what they could stop locally but would have to await NHS England’s decision.

On Tuesday the prime minister Boris Johnson said 400 army medics had been drafted into assist the vaccine drive while tens of thousands of volunteers were being sought.

Trust chiefs pointed out that although anyone can be trained to give a vaccine, only qualified individuals can draw the fluid into a syringe and take a person’s consent.

One said: “Even though we could train a whole army of people to put a needle in somebody’s arm, you still need qualified people to do the consent and draw up the needle.”

One senior trust director in the East of England told The Independent : “We don’t have enough staff to manage the vaccination we have now, it will lead to a massive additional load of work. The chances are it will take staff away from the services we’re still struggling to get running.”

Another chief in the Midlands said although they were still awaiting guidance, their organisation would “probably scale up and offer the vaccine to everyone but it will have a significant impact on core service capacity.”

The added: “We have to prioritise safety and non-urgent care so the hit will be on routine care again.”

Although one chief executive in the South of England said their trust would likely be able to meet the government’s deadline with existing staff and the assistance of community pharmacies, it would be “tight.”

Chris Hopson, chief executive of NHS Providers, which represents all NHS hospitals, said: “The NHS’s job is to provide the best care to all those who need it, as quickly and effectively as possible. Given the vital importance of the booster campaign, trust leaders know they will need to balance its extra demands with current pressures in emergency care and treating care backlogs.

“Trust leaders will always do all they can to avoid scaling back activity but, when required, they will prioritise on the basis of clinical need, which they are very experienced at doing”.

A Department of Health and Social Care spokesperson said: ““Over the coming weeks hundreds of military personnel, 1,500 community pharmacy sites, additional hospital hubs and pop-up sites will help the NHS deliver these vital jabs at speed.

“We continue to work closely with the NHS as they expand the rollout of the booster programme to ensure they have the support they need to tackle the backlog and provide care to patients.”

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