Over the last three years, we've grown accustomed to receiving daily updates on the number of new cases, hospital admissions, deaths, and vaccination status. However, COVID-19 had indirect effects on people's health, such as less use of and disruption to healthcare for non-COVID conditions such as cancer, a growing backlog of healthcare, an increase in the number of people with undiagnosed disease, and a deterioration in people's mental health.
While the respective healthcare services across the UK have faced many similar challenges during this period, UK-wide reporting has masked any difference in peaks and troughs across the four countries. This reflects how COVID-19 has spread over time, as well as the impact of new strains of the virus and lockdown rules, among other factors.
Though these were the common effects of COVID-19 on the rest of the world, the extent of the impact is what actually has to be looked into. Let's look at how COVID-19 has affected the UK on the international stage.
COVID-19 has impacted the number of deaths and also altered the life expectancy of people. From January 2020 to June 2021, there were more deaths in the UK than in most other Western European and high-income countries. The life expectancy in the UK fell in 2020, along with a few other countries in the Organization for Economic Co-operation and Development (OECD). However, this doesn't explain why the UK's life expectancy before the pandemic was much lower than in many other countries, especially for women, and why it had some of the slowest gains in the decade before.
Moreover, as the NHS is still battling a raft of respiratory illnesses this winter, including flu and the new COVID-19 subvariant XBB.1.5, this is causing immense strain on vital services. As there has been only a little change in the COVID-19 situation and the health system in the UK, experts expect that it will take some time for the life expectancy of the country to bounce back.
The reason for the recent spike in COVID-19 cases might be the relaxation of restrictions (as the current travel restriction is only applicable to travellers from China); health chiefs and scientists have already advised people to don masks and call out for booster doses. The pre-pandemic situation was not much better, as the UK population had to suffer from a shortage of nursing staff, leading to a lack of proper health and quality care. In the UK, there are lags in cancer survival rates, case-fatality rates for heart disease and stroke, "avoidable" mortality (i.e., deaths that are potentially preventable or treatable by healthcare), and infant mortality. However, the UK's performance on flu vaccination, breast cancer screening, diabetes care, suicide following psychiatric admission, and prescribing cheaper, generic drugs is commendable.
A key strength of the NHS compared to other countries is that it assures universal coverage, and cost is generally not a barrier to access. However, for the past decade, the NHS has been under-resourced relative to other high-performing healthcare systems. Although global spending on healthcare after the advent of COVID-19 has increased, the UK's per capita spending has been lower. The UK has fewer doctors and nurses, as well as fewer hospital beds and diagnostic equipment than most other high-income countries.
This longstanding underinvestment in healthcare staff and infrastructure meant that the UK entered the COVID-19 pandemic with an already overstretched healthcare system. As a result, the NHS is having a hard time dealing with the effects of the pandemic, such as tired staff, a large and growing backlog of care, and growing differences in healthcare.
Due to these shortages, the country has little spare capacity and is vulnerable to acute shocks such as the COVID-19 pandemic. Also, they have caused waiting lists for elective care to grow. By 2022, over 6 million people will be on a waiting list just in England.
Historically, health spending in the UK has gone through cycles of sustained growth and austerity. Nevertheless, total healthcare expenditure has increased in the last decade, reaching just over 10% of GDP in 2019. Around 80% of all money spent on healthcare comes from the government, which has stayed the same for the last 20 years.
Consequently, UK citizens enjoy high levels of protection against the financial consequences of ill health and minimal out-of-pocket payments.
The predicted economic impact of COVID-19 on productivity rates, as well as the social consequences of distancing measures, have received considerable attention. But what about the social and economic effects on individual healthcare workers and their households?
According to the World Economic Forum, even before the COVID-19 pandemic, the UK's healthcare system heavily depended on temporary nursing staff to fill the gap in the workforce. Like other "zero-hours" contract workers, these temporary workers lose money because they are alone and may not have access to social services.
Still, COVID-19, like any other pandemic, has affected people in different ways. This is because these infections are typical of the medical poverty trap, in which poorer people tend to have worse outcomes.
Also, when the UK government said it would bring back retired healthcare workers during the crisis, people were worried, as even though they had valuable experience and skills, a lot of them were vulnerable to COVID-19 problems.
Similar to any other world economy, even the UK's healthcare economy had to suffer drastically. Even prior to the mobilisation of pandemic funds, the healthcare economy was unable to provide even basic care and services. As a result, the COVID-19 onslaught in the UK's healthcare economy accelerated.
As the number of COVID-19 cases rose during the second and third waves, the economy of the UK as a whole was affected, and the worst was faced by the healthcare industry. The lack of equipment to deal with the COVID pandemic, insufficient staff, and lack of funding all affected the healthcare economy largely.
Even when the COVID-19 crisis was at its worst, Nurses Group was able to provide temporary nurses to different healthcare facilities. This allowed them to be a part of one of the biggest healthcare battles in the country.
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