It includes the return of urgent outpatient appointments to the same levels as before the outbreak, and regular testing being offered to staff even if they do not show symptoms.

The NHS was also warned to prepare for a possible long-term increase in demand for mental health services “as a consequence of the pandemic”.

In a letter to GPs and regional trusts, NHS Chief Executive Simon Stevens and Chief Operating Officer Amanda Pritchard thanked NHS teams for their response to “the greatest global health emergency in our history.”

They wrote that on March 17 the NHS initiated the “fastest and most far reaching repurposing of NHS services, staffing and capacity” ever.

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The letter then goes on to detail how the NHS will operate over the coming weeks as the virus looks set to continue, though hopefully with weekly decreases in patients.

But the letter adds that despite the service preparing to enter its second response phase, the pressure on NHS staff “will remain unprecedented.”

Some services will be brought back up to pre-Covid-19 levels, though, including referrals, diagnostics and treatment for cancer, “at the earliest opportunity to minimise potential harm”.

And the availability of booked appointments in urgent and routine surgery will be increased, and, if additional capacity is available, the restart of routine electives is recommended.

Elective surgery refers to operations that have been planned in advance, as opposed to emergency ones.

And GPs are encouraged to continue using online consultations. The letter claims that over 85 percent of general practice consultations are being managed remotely.

In contrast, this is a move from 90 percent of consultations being carried out face-to-face previously.

In recent weeks, the letter adds that “emergency activity” has fallen significantly – emergency hospital admissions were at 63 percent of the same time the previous year.

This is “likely” because of a reasons including a change in people seeking healthcare in the first place, as well as a reduction in “major trauma” and road accidents.

But this fall in emergency activity will likely lead to a rebound in emergency demand, the letter notes, with “considerable uncertainty” as to when and how severe this rebound will be.

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The NHS heads called for the sourcing of PPE to be expanded, not just for the NHS but for other affected sectors including social care.

The letter also references emerging global and UK data which suggests that people from black, Asian and minority ethnic (BAME) backgrounds are “being disproportionately affected” by Covid-19, and so staff from these backgrounds should be “risk-assessed” as a precaution.

And trials are being carried out this week in a number of health providers for the regular testing of asymptomatic staff.

In its introduction, the letter provided an overview as to the NHS’ response to the Covid-19 outbreak so far.

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It reads: “Despite real concern going in to the pandemic – following difficult international experience – every coronavirus patients needing hospital care, including ventilation, has been able to receive it.

“This has largely been possible as a result of the unparalleled commitment and flexibility of NHS staff, combined with the public’s ‘social distancing’ which remains in place to cut the spread of the virus.”

The letter adds that the virus “looks set to be with [us] for some time to come, so we will need continuing vigilance.”

“We are, however, now coming through this peak of hospitalisations, as seen by the drop of nearly 5,000 in the daily number of confirmed Covid19-positive patients in hospitals across England over the past fortnight.”

The NHS will move into its phase three recovery period “at the right time”, the letter adds.

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