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The fourth of July may not traditionally be a cause for celebration in England, but NHS trusts have been told to gear up and expect the same level of activity as on new year’s eve, according to a note seen by HSJ, as next weekend will see pubs and restaurants opening for the first time since March.

At least two regions have been sent the email from the national commissioner, which has told them they must “ensure that your demand/activity planning reflects a busy weekend, with peaks in activity into the evenings similar to that of new year’s eve”.

As anyone working in healthcare will know, new year’s eve is notoriously busy for A&Es, with many people getting injured and ill on nights out.

A chief executive in the North West – one of the regions where the email was sent – said they had already started to see A&E attendances creep up as lockdown has been eased. They also reported a change in the type of injury, including those alcohol related.

The worn-out workforce will surely be hoping the public enjoy the coming weekend in moderation, even with the greater freedoms it brings.

Community holds the key

The NHS is getting seriously worried about winter.

How would it cope with a second peak of coronavirus, as well as an onslaught of other respiratory cases?

Part of the service’s answer seems to be a mass increase in community-based beds, which could be used for covid rehabilitation or other step-down patients.

In the North West region, leaders have been asked to prepare plans for up to 900 beds dispersed across multiple localities, rather than centralised in large facilities, such as the little used Nightingale facility in central Manchester, which has now been mothballed.

NHS England has suggested capital funding could be available, HSJ was told, and the North West plans could require tens of millions of pounds to deliver. Significant revenue funding is also likely to be needed.

The North West moves are a likely indication of a national plan to expand bed capacity across England ahead of a possible second peak. Crudely, if the 900 figure was repeated in other regions, it may amount to more than 6,000 additional beds England-wide.