Even before covid-19, the NHS was in need of some emergency treatment. In the 2019 general election 1 the UK government promised 50 000 more nurses, 6000 more general practitioners, and another 6000 other primary care professionals in addition to the 20 000 already promised. The reason for these commitments was easy to see: widespread staff shortages and a slow but steady decline in many key markers of performance, whether in elective or accident and emergency care (where data are good) or in

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... neral practice, mental health, and community services (where they aren't). Covid-19 then intervened, causing a massive disruption to services. At their lowest point, GP referrals to hospital fell by around 75% from the previous year, 2 diagnostic tests by 70%, 3 emergency admissions by just under 40%, 4 and GP appointments by about a third. 5 Elective activity is back to around 90% of pre-covid levels, 6 although in any normal year a 10% fall in activity would still be shocking. 3 NHS England. Monthly diagnostic waiting times and activity. 2020-2021. https://www.england.nhs.uk/statistics/statistical-work-areas/diagnosticswaiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/ 1