Lifting lockdown without new measures in place risks deepening the crisis in the NHS and will leave hospitals and GP practices overwhelmed, the British Medical Association (BMA) has warned.

The trade union and professional association representing doctors in the UK has released a blueprint for England leaving lockdown, with recommended measures in place to stop the spread of the virus from getting out of control.

The BMA said the government must learn from the first lockdown, where “rapid relaxation of infection control policies, inadequate monitoring, and encouragement to socially mix in restaurants and bars, and to return to work, resulted in a surge of virus spread, leaving us unprepared to face autumn and winter”.

It is calling for the new measures to be brought in to bridge the time between the planned end of lockdown in England on December 2, and an effective vaccine programme getting underway.

As it stands, the government plans to go back into a tiered system on a local and regional basis from December 2. The precise details of what will replace the national lockdown will not be revealed until parliament is told next week. 

Dr Chaand Nagpaul, the BMA’s chair of council, said: “We must not squander the efforts of the many people who have followed the law, stayed at home, sacrificed freedoms and incurred financial loss in order to contain the virus.

“When the first lockdown ended, there was no coherent plan for keeping Covid-19 at bay, no clear and simple public messaging; this was followed by spiralling infection rates, more businesses failing, new ‘local’ lockdowns, and now we have a death toll at more than 52,000.”

Downing Street has said it wants to relax lockdown rules to “ensure that people can spend time together over Christmas”.

So, what does the BMA suggest?

In the report, the BMA details the steps required to control Covid-19 in a three-phased approach.

Phase One

Before lockdown ends, there needs to be wide-scale reform to the testing and contact tracing programme, the BMA said, and more money for track and trace needs to be given to local public health teams.

Phase Two

Once England exits lockdown, doctors want to see far more effective and robust national measures up and running to reduce infection rates and keep the virus at bay. These include: 

• Replacing the ‘rule of six’ which allowed mixing of up to six households with a ‘two households’ rule to reduce social mixing.

• No travel between or across different local lockdown tiers.

• The publication of rules, rather than guidance, for the creation of Covid-19 secure environments in public settings, hospitality and workplaces and for the rules to be enforced.

• Encouraging people to work from home where possible.

• Practical changes to the NHS Covid-19 app so it provides infection information at a local level and guidance in a simple ‘airline safety’ style.

• Targeted support for clinically extremely vulnerable individuals and for communities that have been hit hardest by the pandemic, including BAME communities.

Phase Three 

This would involve the widespread uptake of a safe and effective vaccine, which doctors consider to be the best way of tackling Covid-19, protecting vulnerable people and easing economic and societal restrictions.

The BMA warned it needs to be properly planned and resourced and the government must use this time to do this.

“GP practices need information and support, so they are ready and able to provide the vaccinations,” reads the report.

It said as more vaccines become available, there needs to be national and local public information campaigns to help everyone know how where and when they can be vaccinated.

“As England prepares to exit its second lockdown, it is unthinkable that we make the same mistakes again because this time, the impact will be far worse,” said Dr Chaand Nagpaul. “It’s reasonable to conclude, that without these measures, the NHS will not be able to cope with caring for even the most critically ill patients.”

A Department of Health and Social Care spokesperson said: “As we’ve set out, we will seek to ease restrictions on Wednesday 2nd December, going back into a tiered system on a local and regional basis according to the latest data and trends.

They added: “Guidance on infection control measures such as returning to work, social distancing and household mixing are constantly under review to ensure we can visit loved ones and support the economy whilst controlling the spread of the virus.”