Every hospital in the UK is under significant pressure and a new Covid surge is “a very heavy straw on the camel’s back”, health leaders have warned.
At least eight hospitals declared a critical incident, cancelled operations or asked people not to come to A&E unless they were seriously ill last week. One of Britain’s most senior emergency doctor said there were links between incidents like these and the rapid rise in hospitalisations for Covid, up nearly 37% in a week to 7,024. While the Office for National Statistics said it was too early to say if an autumn Covid wave had begun, health leaders said ministers need to urgently address staffing shortages.
Dr Adrian Boyle, the incoming president of the Royal College of Emergency Medicine told the Observer: “Our system is under-resourced. We don’t have enough beds, and we don’t have the workforce for the demand that we’re being asked to deal with.
“Covid just makes everything that much harder and it’s entirely valid to link this with critical incidents being called around the country. All hospitals are feeling significant levels of pressure at the moment. Covid is a very heavy straw on the camel’s back.”
The first signs of an increase in Covid infections came in southwest England. Last Friday, NHS Devon warned people of “longer than usual waits” in emergency departments. NHS Devon’s chief nurse Darryn Allcorn said people who came to A&E without a life-threatening emergency “may be directed to a more appropriate service”.
Hospital trusts in the Midlands and north have all announced they were struggling to cope with demand. Nottingham University Hospitals Trust declared a critical incident, postponing some operations due to extreme pressures, and by Friday the alert was expanded to cover the whole of Nottinghamshire.
In neighbouring Lincolnshire, routine operations at the Diana, Princess of Wales hospital in Grimsby were cancelled, with Northern Lincolnshire and Goole NHS Trust saying there had been a significant increase in people attending A&E.
Royal Liverpool hospital said it had very limited space in emergency departments and St George’s hospital in London asked people to go to A&E only in serious situations.
Boyle, who takes up his position this week, said the first sticking-plaster should be applied to social care. “We need to use what beds we have as efficiently as possible. That means sorting out social care, so people aren’t kept in hospital waiting to leave.”
The spectre of a “twindemic” of flu and Covid means that winter “could become very grim,” he said – “like two playground bullies getting together and forming a gang”. “What’s happening with urgent and emergency care, particularly ambulance handovers and long waits in emergency departments – this needs to become a political priority. We need leadership and we need grip and investment.”
Last week, research by the Nuffield Trust revealed that record numbers of nurses were quitting the NHS, with one in nine leaving their jobs.
Pat Cullen, the general secretary of the Royal College of Nursing, said that an increase in Covid infections and hospitalisations “should be a cause for concern”, and called for nurses to get access to the highest quality PPE.
“As we head into winter it is important that healthcare leaders remain vigilant and stand ready to act to prevent any further spread of the virus. We all saw what happened last winter and nobody wants to take a backwards step.”
Saffron Cordery, interim chief executive of NHS Providers, said trusts had become more adept at dealing with Covid by, for example, setting up “hot” and “cold” sites.
“But we need to be clear that we’re back at levels with the R rate over one in lots of places. We need to think about the impact not just on patients but also on staff, and what it means for them to be going through this yet again. With a twindemic this winter, we’re going to see a spike in demand and more staff are going to be absent.”
She said Thérèse Coffey, the health secretary, should be focusing on vaccinations and supporting the NHS workforce.
Dr Veena Raleigh, senior fellow, The King’s Fund said Covid was the sixth leading cause of death, with more than 300 people dying each week.
“[That is] a stark reminder that this virus remains a threat for the foreseeable future,” she said. “Although it is early days, this rise in cases is consistent with what’s been expected as winter approaches. Acting now to prevent further hospitalisations and deaths is crucial.”
People at higher risk of Covid should get vaccinated as soon as possible, Raleigh said. “This is especially important for people from deprived and ethnic minority communities, given the disproportionately brutal impact Covid-19 has had on them.” Mask-wearing on public transport and in crowded places would also help, she added.
“Since spring this year, overall deaths have been significantly higher than expected compared with previous years, in part due to Covid-19 deaths. There’s a real risk that the toll of excess deaths could mount. The NHS was over-stretched even during the summer months when demand for health care is normally lower, and winter will bring added pressures. We therefore urge the Government to address the longstanding staffing and funding deficits in NHS and social care services that pre-date the pandemic and continue to limit the ability to meet patients’ needs.”