As levels of Covid-19 once again increase across the UK, the health service is applying lessons it learnt over the past six months in the hope of averting another crisis. © Christopher Furlong/Getty Images

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The UK government has ordered more than 30bn items of personal protective equipment and built up a four-month stockpile of kit as it seeks to avoid the shortages that put NHS staff at risk during the first wave of coronavirus.

Under a strategy expected to be unveiled later this month, the government is also aiming to have a large majority of PPE items manufactured in the UK by next March, eliminating potential overseas bottlenecks, according to one person familiar with the plan.

Shortfalls of PPE led to widespread complaints that staff were working in unsafe conditions during the first phase of the pandemic. Some grieving family members even blamed the lack of protective equipment for the deaths of their loved ones.

As levels of Covid-19 once again increase across the UK, the health service is applying lessons it learnt over the past six gruelling months in the hope of averting another crisis.

While much of the nation responded with anxiety or irritation to prime minister Boris Johnson’s announcement this week of further national restrictions, those on the NHS frontline hope that people will listen, and that this will mitigate a surge in virus patients as the service simultaneously copes with the winter pressures it has found hard to manage in recent years.

The warning signs are already flashing, with hospital admissions in England in particular rising in September. On Tuesday numbers admitted across the UK stood at 1319, with 181 requiring ventilated beds; the following day, the number admitted with Covid-19 had increased to 1469, and the number needing ventilators stood at 211.

Line chart of  showing Daily hospitalisations for Covid-19

Layla McCay, director of the NHS Confederation, which represents organisations across the healthcare sector, said the service had learned from the huge logistical challenges in March to ensure NHS organisations had the kit they needed.

“It was incredibly difficult rapidly to convert the PPE system used in ordinary times to meet the much-expanded need [to cope with] Covid-19. Now that system exists and what I’m hearing from everyone is it’s in a much better place to provide the PPE that is required and keep staff members safe,” she said.

There has also been progress in tackling the severe bed shortages that contributed to the cancellation of swaths of non-emergency treatment during the first wave of the virus, creating a huge backlog of patients needing care.

David Oliver, a consultant in geriatrics and internal medicine at a hospital in the south of England, said: “Elective planned care was sacrificed on the altar of urgent care and not overwhelming the NHS. Now we are playing catch-up.”

However, across the NHS there is growing confidence that Covid care will not have to obliterate many other services in the way it did during the earlier peak.

One reason is that some large hospitals are creating more critical care beds, a category in which the NHS has long been deficient compared with other health systems.

Marcel Levi, chief executive of University College London Hospitals, said his hospital, along with other big institutions in the capital — such as the Royal London, Guys and St Thomas and the Royal Free — was already implementing plans to double the number of intensive care beds after having the proposals approved by the NHS’s regional and national teams.

However, Prof Levi said the Treasury had yet to give the green light for the additional capital expenditure, and he was “surprised by the lack of any pace by decision-making people higher up”. He added: “Most hospitals think it’s so important that we have just started these preparations, but it is a very risky situation when the money is not settled.”

Prof Levi stressed that while his own hospital “was still doing a lot of cancer treatment, a lot of cancer surgery, a lot of non-Covid emergencies” during the height of the pandemic, in the next peak “we also want to keep the planned surgery and diagnostics going because we cannot afford to have a further increase in the backlog of all these procedures for patients”.

He also suggested that because doctors had learned a huge amount about how best to treat Covid-19 sufferers, the period they occupied intensive care beds had reduced considerably. In most European countries the average length of stay had fallen from 21 days in the earlier part of the pandemic to “more like 10 days”. “It means you have twice the number of ICU beds available”, Prof Levi said.

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Improved treatment was less about finding a single “golden bullet”, in the shape of a miracle drug, he added, but “a combination of 15 or 20 little things that we’ve learned that have made the difference”.

However, one issue that emerged during the pandemic and has not been addressed is the disproportionate impact the virus has had on people from black and minority ethnic communities. A government report into how the risks might be mitigated has not been acted upon, according to Chaand Nagpaul, who chairs the ruling council of the British Medical Association.

Dr Nagpaul said: “The sad fact is the most recent data shows a third of intensive care beds are still occupied by patients from Bame backgrounds and that is the same statistic as back in April, when the government first announced this inquiry. Now it’s September and nothing has changed.”

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