What are the impending threats to the NHS this autumn?

The health secretary, Steve Barclay, has warned the NHS faces serious challenges this autumn. We take a look at the growing pressures on the healthcare system.

Covid

As the UK emerges from one wave of Covid, driven by the BA.4 and BA.5 subvariants of Omicron, experts have predicted at least one more will hit in the autumn and winter.

It is not yet clear which variant, or variants, such a wave will involve, but ensuring those eligible have received their autumn booster will be crucial in order to keep levels of severe illness low.

That may be a challenge. Despite infections soaring during the summer and a spring booster programme on offer, the UK Health Security Agency (UKHSA) noted that, by late June, 17.5% of people aged 75 years and over had not had a vaccine within the past six months, leaving them at higher risk of severe disease.

Influenza

Australia has experienced a particularly bad flu season, with the virus hitting earlier and harder than usual, raising concerns that the northern hemisphere could face a similar surge in infections later this year.

The situation is, in part, down to the very low levels of flu in recent years as a result of lockdowns and other measures, which has meant there has been a waning of immunity in the population, leaving people more vulnerable to flu.

Promoting uptake of flu vaccines this winter to all those eligible will be important to reduce both the number of hospitalisations arising from flu, and wider pressures on the NHS.

Cost of living crisis

As the costs of energy and food rise, experts have warned the NHS could come under extra pressure. One concern is that chilly homes could mean an increase in sickness among those with conditions that are exacerbated by the cold, such as heart disease and chronic lung disease.

An inability to eat adequately can also affect the body’s ability to stay warm, while some experts have even warned there could be a rise in cases of malnutrition, particularly among children.

Workforce shortages

According to the cross-party Commons health and social care select committee, the NHS is facing “the greatest workforce crisis” in its history, with estimates from the Nuffield Trust suggesting that in England alone there could be as many as 50,000 vacancies for nurses and 12,000 for doctors.

Additionally staff shortages in social care have led to problems with discharging patients from hospital – a situation that has contributed to ambulances spending hours queueing outside hospitals waiting for beds for their patients, and crowding in A&E.

While Barclay has placed an emphasis on the need to hire staff from overseas, some have raised concerns that there could be ethical conundrums, warning the approach could deprive developing countries of their own highly trained staff.

Pay

While the government has recently revealed details of a pay rise for NHS staff, the figures involved have been criticised with the British Medical Association noting the offer of a 4.5% award to some doctors this year is far below the rate of inflation, while junior doctors – who have an annual 2% pay rise, agreed before the pandemic – get no further increase.

In addition, senior doctors are locked in a battle over limits on tax-free pension contributions – a situation which has led some consultants to turn down shifts or even retiring early to avoid hefty tax bills.