Restricted access to the NHS during the COVID-19 pandemic: Is it time to move away from the rationed clinical response?
Daniel Goyal, Fatma Mansab, Adeeb P Naasan, Amir Iqbal, Colin Millar, Grant Franklin, Stephen R. Thomas, John Mcfadden, D. C. Burke, Daniel Lasserson
Abstract
Recently a Lancet Commission examined the future prospects of the NHS in the wake of COVID-19. The report cites poor healthcare capacity and chronic staff shortages as key contributing factors to the UK’s inadequate pandemic response. Notable strengths included universal access, the goodwill of staff, and the ability to generate innovative solutions - qualities that are likely to have averted an even deeper national crisis [1]. \n \nThe prosperity of the NHS is intrinsically connected to the prosperity of the nation. Access to healthcare influences morbidity, mortality, economic activity, and whether or not social restrictions are necessary [2,3]. Public health measures such as timely implementation of social distancing are also important to limit mortality, but going forward it is the capacity to respond in a clinically effective and decisive manner that is vital to diminish the threat associated with the virus [4]. \n \nThe importance of examining the national clinical response to SARS-CoV-2 cannot be overstated. Arguably the greatest mistake of this pandemic would be failing to prepare for the next. There are also the looming unknowns of SARS-CoV-2 variants [5], the higher rates of Long COVID following more severe disease [6], and the increased healthcare demands associated with delayed presentation of COVID-19 pneumonia [7-11]. Improving the tolerance of society to background levels of SARS-CoV-2 will require an improved clinical response. With this in mind, we examine one aspect of the UK’s clinical response that remains in place today: restricted access to healthcare.