Report highlights achievements of NHS trusts after ‘tearing up red tape’

The NHS has generated 33,000 extra beds to cope with Covid-19 after giving unprecedented free rein to individual trusts to transform both their processes and infrastructure, healthcare chiefs said.

A report from NHS Providers, a body representing more than 200 NHS trusts in England, said media focus on the new field hospitals ignored how much spare capacity had been created in hospitals in a matter of weeks.

The 33,000 beds are the equivalent of building 53 more district general hospitals across the country.

The report found that by “tearing up red tape” and ditching “the myriad of regulations that have ossified existing structures and ways of doing things”, the NHS has been able to adapt at incredible speed.

“Healthcare provision carries lots of risk so some level of regulation will always be necessary,” it said.

“But it’s amazing how much has been achieved how quickly with a significantly lighter, and more flexible, approach to regulation.”

NHS Providers chief executive Chris Hopson said the purpose of the report was to “fill the gap” in the media coverage on the practical steps being taken by hospitals to meet the challenges they face.

Many trusts have boosted capacity by overhauling discharge processes so medically fit patients who would normally have to wait for a care home place or social care package can be released immediately.

With the help of mental health trusts, hospices, local government and social care, the majority of these patients are now having plans for their ongoing care organised in their own homes.

Medically fit patients account for 20% to 30% of most NHS trusts’ patients, and in one case these changes cut the number of patients ready for discharge from 250 to 20 in a fortnight.

An extra 8,000 hospital beds, 1,200 more ventilators and 18,700 clinical staff have also been secured through a deal with private sector healthcare providers.

The report said ambulance services have ramped up the numbers in their fleet by working round the clock to refit new vehicles as well as temporarily drafting in members of the fire service to boost staff numbers.

Mental health services have contributed by creating empty wards so acute hospitals can transfer non-coronavirus patients, and retraining staff so they are able to provide physical care.

The report also praised the involvement of the armed forces, who have assigned a liaison officer to each NHS regional team to channel requests for help and prioritise them accordingly.

“The result has been a much-needed immediate increase in capacity, right across the country, in key areas such as logistics planning, construction and transport,” it said.

The report added: “Trust leaders have been empowered to change what their trust does at the drop of a hat – they’ve been given a clear objective and told to do whatever they thought was best.

“That’s then cascaded down throughout the rest of the trust – frontline teams have been able to change how they work to best meet what they know needs to be done.”

It said that by having the support of a wide number of partners – from the Army, hundreds of thousands of volunteers, specialist suppliers and other public services – “the NHS has been able to achieve things it could never have done by itself”.

The rapid upskilling of staff and the willingness of those in clinical roles to move into new areas of work where they have little or no experience has also meant hospitals have been more able to cope.

But the report warned many were having to work with different patient-to-staff ratios and much less expert supervision than normal, considerably adding to the difficulty of their work.

It said that even if the crisis were to peak within the next few weeks, staff might still be expected to work flat out in the coming months, in real fear of their safety, with no let-up in sight.