England's National Health Service can run 24-hour vaccine clinics and send some patients to hotels under plans set out by health leaders.
The NHS has been put on its highest level of emergency readiness as it prepares to tackle the “new and significant” threat posed by the Omicron coronavirus variant.
The health service declared a “Level 4 National Incident”, which means that local bodies will not have the autonomy of response in their areas, with the NHS taking responsibility.
A letter written by NHS England’s chief executive Amanda Pritchard and national medical director Prof Stephen Powis said the emergence of the variant requires an “extraordinary response” from the NHS.
The letter states that the NHS will deliver “more vaccines over the coming weeks than ever before”, which might include 24-hour vaccine clinics “where relevant for the local community”.
Vaccine sites should operate 12 hours a day “as standard”, seven days a week, while some GP appointments will need to be postponed as the NHS gives priority to the vaccination programme.
“Even with the additional protection that vaccine boosters will give, the threat from Omicron remains serious," the letter said.
It says the number of people requiring care could be “significant over the coming period” as it set out steps for the NHS to prepare for a new wave of cases.
This includes discharging medically fit patients to hotels and increasing the use of private hospitals.
Pressures in the social care system mean that many patients can usually be left in hospital while packages are arranged.
But the NHS has ordered hospitals to free up as many beds as possible, which could include discharging fit patients to hotels to wait for social care support to be put in place.
Health leaders have also been ordered to make “full use of non-acute beds in the local health and care system”, including the use of beds in hospices and private hospitals.
They have also been told to expand the use of “virtual wards”.
Hospital bosses have been asked to “surge test”, including testing oxygen supplies, and “learn the lessons from previous waves of Covid-19, and make preparations to have the capacity in place to meet a potentially similar challenge this winter”.
Local trusts have been ordered to maintain mental health, learning disability and autism services.
Meanwhile, they have been told to give priority to pre-planned care for “highest clinical priority patients”, which includes those with cancer and those who have been waiting the longest.
The letter says that services should be maintained “as much as possible”, but recognises that some staff may need to be sent to support vaccination work.
And plans to employ more staff should be accelerated, including asking international nurses to go to work in the UK where possible.
“The past two years have arguably been the most challenging in the history of the NHS," the letter said.
"But staff across the NHS have stepped up time and time again to do the very best for the nation – expanding and flexing services to meet the changing demands of the pandemic; introducing new treatments, new services and new pathways to respond to the needs of patients with Covid-19 and those without; pulling out all the stops to recover services that have been disrupted, whilst rolling out the largest and fastest vaccination programme in our history.
“The Omicron variant presents a new and significant threat, and the NHS must once again rise to the national mission to protect as many people as possible through the vaccination programme whilst also now taking steps to prepare for and respond to this threat.”
British Health Secretary Sajid Javid told the House of Commons that the NHS had returned to its highest level of emergency preparedness.
“This means the NHS response to Omicron will be a co-ordinated as a national effort, rather than led by individual trusts,” Mr Javid said.
England’s chief medical officer, Prof Chris Whitty, said the NHS was “once again facing a rising challenge” and thanked health staff for their efforts.
“NHS staff have worked with skill, integrity and determination through very difficult circumstances for a long time," Prof Whitty tweeted.
“As millions come for boosters and pressures increase on the NHS, we are once again facing a rising challenge. A profound thank you for all you are doing.”