What can statistics tell us about the state of the NHS upon the outbreak of the SARS-CoV-2 pandemic?

This paper draws upon selected statistics to paint a picture of a National Health Service which was not only ill-prepared for the pandemic, but the resilience of which had been undermined by policy, especially during the decade leading up to the pandemic. The paper argues that financial constraints, failure to care adequately for the workforce and the ongoing closures of hospital beds in a context of rising pressures had resulted in the health service having insufficient capacity to meet health needs even prior to the pandemic. The policy priority of restructuring health services and the shrinking of the NHS estate, reflecting in part inadequate capital investment, distracted attention from pandemic preparedness and reduced the room for flexibility available to NHS managers when large numbers of infectious patients began to be admitted to hospital. Public health had been significantly damaged by reductions in its budget and by its three-way partition in the 2012 Health and Social Care Act, reducing its ability to mount an effective and coherent response to the pandemic crisis. The capacity of primary care and NHS 111 were insufficient to meet need even before the impact of the pandemic was felt and social care, upon which the NHS depends for the effective use of its own resources, had been debilitated by chronic underfunding and the application over many years of competitive market forces in a context of severe financial constraint.