COVID-19 and respiratory illnesses could result in a “perfect storm” this winter, ruining plans to deal with the backlog of patients needing NHS care.

Some 78% of NHS trust leaders in England are extremely or moderately concerned about the operational pressures their trust faces this winter, according to a survey by NHS Providers.

Among the concerns are a possible increase in demand for urgent and emergency care, as well as flu cases.

Almost nine out of 10 said they expected another surge in COVID-19 cases which would put extra pressure on health workers.

The chief operating officer of a community trust in the South East told NHS Providers: “I am worried that we will have a difficult flu season and we will have a run on the beds.

“This will destabilise the elective (planned treatments) recovery which will be very concerning given the length of time patients have already waited.”

Health Secretary Matt Hancock has promised a significant flu vaccination programme this winter and there is also discussion of COVID vaccine boosters, although it has not been revealed which parts of the population will receive the latter.

The survey also showed that 73% of respondents were extremely concerned about disruption to work under way to clear the backlog of patients.

These patients were mostly postponed during the pandemic due to the need to prioritise those suffering from COVID-19.

Almost half of respondents said they had seen evidence of staff leaving for early retirement, COVID-19 burnout or other effects of working in the pandemic.

Deputy chief executive of NHS Providers Saffron Cordery said trusts are “battling on multiple fronts as they try to recover care backlogs, deal with increased demand for emergency care and treat patients with COVID-19”.

“This is difficult at the best of times but, as we saw last year, could become even more challenging during the hard winter months, particularly with the expectation that flu will return and there will be increased respiratory viruses among children.

“Trusts are committed to clearing the backlog of care that built up during the pandemic.

“We are confident vaccines are breaking the chain between infections and hospital admissions, but the reality on the frontline is that even a small increase in COVID-19 admissions or emergency care pressures could affect our ability to deliver non-COVID services.”

An NHS spokesman said: “Throughout the pandemic, NHS staff have worked tirelessly to face the biggest public health emergency in NHS history, responding to demand for services by expanding hospitals’ critical care capacity by 50%, managing admissions through mutual aid between hospitals and working with the independent sector.

“As we battle the global pandemic, we continue to use these tried and tested robust measures and we are working with trust leaders to ensure hospitals continue to offer patients the care they need while tackling the waiting list backlog and vaccinating the country against COVID, as well as looking ahead to winter.”

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