The risk to the NHS of a Covid-19 winter

September 6, 2020 • Reading time 2 minutes

Published 7 September 2020


Edge Health analysis originally published by the Guardian

Covid: at least six English NHS trusts could be overwhelmed this winter; Pamela Duncan and Ashley Kirk; 7th September 2020


Unlike some of the scenes from other countries, the NHS was largely not overwhelmed by Covid-19 in April. This was due to a colossal drop in demand for NHS services, the cancellation of operations, and an increase in critical care bed capacity – ultimately, this meant the NHS become a National Covid Service.

With the additional impact of ongoing infection control measures, we estimate up to 10 million people could be on a waiting list by April 2021- more than double the number at the start of 2020. This includes cancer patients, whose diagnosis and treatment will impact their survival. To prevent this growing further still, it is important to understand the pressures that Covid-19 placed on the NHS.

Had normal activity persisted in April, the NHS would have had too few beds also to manage Covid-19 – particularly at some hospitals and more so for critical care than ward beds. Maintaining normal services at the same time as managing the Covid-19 crisis would have led to even greater strains on the NHS workforce (who may have had to pick who gets a bed or not) and likely higher mortality rates than were seen.

While the Nightingales were set up rapidly to alleviate the pressure on the NHS from Covid-19, they never entirely functioned effectively and only treated a few patients. This was partly due to staffing constraints, but also the effect of social distancing measures that slowed the spread of the disease.

Now as the NHS braces for a second wave of Covid-19 this winter, it mustn’t again become a National Covid Service. With waiting lists dangerously long, now is the time to learn and act on the hard lessons from the last few months – there is a lot more data and intelligence now than there was in March.

Our analysis was undertaken exclusively for the Guardian. The analysis shows that some hospitals would be overwhelmed this winter if there is a second wave of Covid-19. The charts below show the bed capacity with both normal winter activity levels (based on an average across the last two years) and Covid-19 demands from April this year.

There several reasons why the level of Covid-19 demand will not be seen again – people’s behaviour now is very different from pre-Covid-19. There is also much closer surveillance and monitoring than there was in March. Still, it is crucial to make sure that any increase in the number of admissions to hospital due to Covid-19 do not cause the NHS to stop providing other services.

View full data here:

For all enquiries and questions, please contact George Batchelor at [email protected]


Edge Health are a specialist UK healthcare analytics consultancy that use data and insights to improve the delivery of health and care services, so that better outcomes can be delivered more efficiently.