The NHS is as stretched now as it was during the pandemic’s peak in January and things will get worse, health leaders have warned.

In a letter to Boris Johnson, NHS providers said the next phase in the fight against Covid-19 is likely to be ‘the hardest yet’ given the scale and breadth of pressures the health service is facing.

The letter citied a backlog of care across hospital, mental health and community services, along with record levels of demand for urgent and emergency care.

Growing hospital admissions for coronavirus, increased cases of long Covid, and people suffering from poor mental health are adding to the workload.

The letter said: ‘Many trust chief executives are saying that the overall level of pressure they are now experiencing is, although very different in shape, similar to the pressure they saw in January of this year when the NHS was under the greatest pressure in a generation’.

The letter said hospitals face a ‘significant loss of capacity’ due to enhanced infection control measures and staff self-isolating or missing work due to stress and mental health problems.

Front-line workers are also ‘quite rightly’ taking holidays that were postponed earlier in the pandemic.

The letter, which was also addressed to the Chancellor and Health Secretary, called on ministers to make ‘the right decisions’ over the next month as it finalises NHS funding for the second half of the financial year.

It warned these pressures will probably intensify in the coming months due to Covid-19, expanded vaccination programmes and dealing with what is expected to be one of the most difficult winters the NHS has ever faced.

NHS Providers chief executive Chris Hopson said: ‘The NHS has delivered in an extraordinary way over the last 18 months, often at the drop of a hat.

‘Many NHS chief executives believe the next phase of our fight against Covid-19 is likely to be the hardest yet given the scale and breadth of pressures they face.

‘They are clear that, now more than ever, the NHS must get the funding it needs to win that fight.

‘Trust leaders have strongly welcomed the financial support they’ve received over the last 18 months. It’s been crucial to coping with Covid-19.

‘But the Government is currently stressing the need to repair the public finances and some are arguing that NHS funding can ‘return to normal’.

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‘Trust leaders want the Government to be clear with the public about the scale of the challenges the NHS faces over the next nine months.’

Mr Hospson said trust leaders are ‘seriously worried’ that the current signals from Government indicate the NHS won’t get the funding it needs to address the crisis.

Asked about the letter on Times Radio, he said: ‘What’s particularly striking is how much over the last few weeks our trust chief executives have said the pressure and the shape of the pressure is very different in terms of the Covid caseload is much lower.

‘But if you add all of the things we’ve got going on, full pelt on the backlog recovery, we’ve got record demand for urgent care.

‘We have got growing numbers of Covid cases, we’ve then lost about 10,000-15,000 beds of the normal 100,000 beds to ensure we’ve got infection control in place, we’ve got large numbers of staff self-isolating, we do have growing numbers of staff off with stress and we’re now at peak summer leave.

‘What trust chief executives are saying to us is that if you add all of that together and you have a ‘pressureometer’ where you measure the total pressure, what they’re saying to us is in many cases this now feels as busy as it did and as pressured as it did in January.

‘The shape of the pressure just looks very different.’

The letter called for discharge funding to be continued to free up beds, more financial support for planned operations to make progress on the backlog, and emergency capital funding to expand emergency departments, crisis mental health services and community and ambulance capacity in time for winter.

NHS leaders also said the 3% pay rise for staff must be funded by the government to ensure trusts ‘do not have to eat into other budgets, risking patient care’.

More and continued use of the private sector was another recommendation to help clear the backlog.

NHS providers said there should be no repeat of what happened previously, when the NHS budget for six months was ‘confirmed just 13 days before the start of the new financial year’.

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