1/42 Good to see yesterday’s @thetimes editorial attacking the pandemic of covid misinformation. Here’s my twitter contribution to fighting it, as suggested. Lockdown and covid sceptics continue to consistently misuse cherry picked data to argue NHS not unusually busy.

2/42 NHS trust leaders believe this disinformation is profoundly disrespectful to staff and risks reducing vital compliance with restrictions on social contact. Below is a long two part thread answering the main "NHS not unusually busy" and other NHS related disinformation.

3/42 Much of the disinformation comes from simplistic year on year percentage comparisons of data. Some types of NHS demand are flat or lower year on year. But it’s a huge distortion to argue that these individual statistics mean the NHS is not unusually busy.

4/42 For example, there ARE much lower levels of winter flu year - a global phenomenon. There ARE fewer elective operations - because of covid pressures. And there are many other examples. But there are five problems with cherry-picking/using these individual datasets.

5/42 1. They do not capture anything like the current total level of NHS demand which is very differently shaped due to COVID-19. Traditional, existing, NHS datasets were built to reflect “normal” levels of demand, “normal” operations and "normal" capacity. This isn’t normal.

1/23 We haven't had a lot to celebrate during this pandemic. But achieving the milestone of offering vaccine to the over 70s, health and care workers and the most clinically vulnerable just before target date is a huge cause for celebration, given the scale of the achievement.

2/23 When Margaret Keenan got her first jab in Coventry on December 8th last year, who’d have thought that, by Valentine’s Day, we’d have vaccinated over fourteen million people across the UK in just ten short weeks? Amazing, extraordinary and truly, really, world class!

3/23 I’ve been struck by how much joy and relief has been brought to those doing the vaccinations and those receiving them. A GP told me yesterday that nothing had given him greater pleasure in his long career. And that the patient's relief was sometimes overwhelming.

4/23 It's vital to recognise the extraordinary contribution of the staff and volunteers who have made this happen. One of my close family had their jab yesterday and was in awe of the volunteer standing outside in the freezing cold for a four hour shift meeting and greeting.

5/23 What I wanted to share in this thread was the slightly untold story of some of the extraordinary challenges the NHS has had to overcome to deliver this target. Requiring superhuman effort from NHS leaders and staff, way beyond the call of duty. Five challenges set out below.

1/21 Parliament votes on the new tiered restctions on Tuesday. A lot of comment in today’s papers on what’s happening in the hospital sector. Important questions on NHS capacity, demand, preparedness, Nightingales etc. Thread below sets out NHS hospital trust perspective.

2/21 Have deliberately concentrated in thread on hospitals as this is where current public debate ahead of Tuesday’s vote is. But many of same issues apply to community, mental health and ambulance trusts, all of whom are under the same current level of pressure as hospitals.

3/21 Running a hospital at the moment is much more complex & difficult than normal due to COVID-19. That often doesn’t show up in usual national data that some are currently quoting (e.g. NHS capacity levels below last year / not under real pressure so where's the problem?)

4/21 Remember pre-covid starting context. NHS already had large demand supply mismatch. Insufficient hospital beds. 100,000 staff vacancies. Despite frontline efforts, worst A&E/elective surgery performance in a decade. Huge overstretch in winter (late Dec-Feb) for last 5 yrs.

5/21 COVID-19 then made task massively more difficult in number of ways. Need to treat three sets of patients - COVID-19; planned care with urgent/important backlog cases from first phase of covid that simply can’t wait any longer; and usual emergency patients needing treatment.

1/31 Lots of media coverage, rightly, on huge NHS pressure. What’s cause of, and how widespread, is pressure? How is NHS responding? How serious is this & what’s impact on patients & staff? What’s likely to happen over next few weeks? Long new explainer thread below in two parts.

2/31 WHAT'S CAUSE OF, AND HOW WIDESPREAD IS, CURRENT NHS PRESSURE? Remember overall context. Winter always busiest time of NHS year & NHS capacity always at its most stretched. Last five winters show that, despite increases in capacity, NHS at / over its capacity limit...

3/31 ...Whilst overall staff levels improved in 2020, NHS also entered year with 100k vacancies. Covid makes all this much worse. NHS balancing four sets of patients – winter patients; covid patients; planned care cases, incl. delays from first phase; and those needing vaccine.

4/31 Covid cases rising extremely rapidly, driven by new variant. In England yesterday there were 22,700 covid patients in hospital vs 500 at start of Sept and 19k at top of 1st peak. Just since Xmas Day NHS has had 5,000 more covid inpatients, equivalent to filling 10 hospitals.

5/31 Impossible in a thread to capture full range of regional variation. But, at top level, London/SE/E of England trusts under substantial pressure. Northern trusts seen improvements since Oct but worried covid levels not dropped sufficiently to cope with any third surge.