23/31 WHAT HAPPENS NEXT? Speed at which covid transmission & hospital admissions slow down is key. Some evidence that increases in rate of infection starting to slow in parts of London/SE. Current best guess suggests peak NHS covid demand might be 2nd/3rd week January?

24/31 Trust leaders also worried that usual early January demand spike now imminent and wider cold weather will mean more emergency demand and staff absence. On plus side, infection control measures mean low winter flu levels and, at moment, low levels of norovirus and D&V bugs.

25/31 The next two to three weeks are therefore critical. How much more capacity will London/SE need before the peak of demand is reached? How best to support trusts in North and Midlands if they start experiencing the scale of increase in covid cases recently seen in London/SE?

26/31 Latter point is key. London/SE trusts under huge pressure in meeting demands from new variant. But they started with very few covid inpatients. Northern/Midlands trusts still have many covid inpatients from Autumn second surge so at real risk if they see similar increases.

27/31 This means Government needs to think very carefully. It's vital to stop covid spread to save lives, reduce harm and give NHS best chance to treat all patients who need care. Full national lockdown, tier 5 and national delay to school return all need careful consideration…

28/31 …Particularly since it’s clear that new vaccines, now firmly on-stream with impressive early NHS rollout, offer a permanent way out. So these restrictions will be time limited. Concept of one more heave to get over the immediate hump of this winter more valid than ever.

29/31 KEY MESSAGES FOR PUBLIC. The NHS is still fully open for business. If you need help, please come forward. Contact NHS 111 online or by phone unless a genuine real emergency. Far too many people suffered in silence in first phase, making conditions worse. Help us help you.

30/31 Please follow the rules restricting social contact, however irritating & onerous they may seem. Following these rules is more important than ever given the massively increased transmissibility of new variant, confirmed today as between 40 and 70% more transmissible.

31/31 FINAL THOUGHT. Trust leaders angry that, despite pressure, anti-lockdown/anti-NHS ideologues are still spreading lies & disinformation on how quiet, or badly prepared, the NHS is. They feel it's disrespectful to NHS staff giving their all in near impossible circumstances.