Region experiencing ‘January workload in December’ as covid inpatients rise 45pc

NHS England data shows that regional covid inpatients reached 1,734 yesterday. This compares to 1,194 on 9 December and the previous highest admissions figure of 1,697 seen in mid-April.

Mid and South Essex has seen a steep rise in covid admissions since the beginning of the month, but NHS figures show that Suffolk and North Essex, and Bedfordshire, have also seen rapid growth in recent days. Admissions are also growing in other parts of the region but less steeply.

Figures seen by HSJ show that the Royal Papworth Hospital FT - which has been providing substantial critical care covid capacity for the region - was as of Tuesday 15 December reporting no unoccupied beds in its baseline critical care capacity. A critical care source in the region told HSJ it was not taking transfers as of Wednesday. It could potentially open critical care surge capacity, but this would be likely to require further redeployment of staff and cancellation of planned care.

Another source told HSJ that Mid and South Essex FT, which serves the sustainability and transformation partnership which has seen the steepest rise in covid admissions, were transferring patients to Colchester hospital, part of East Suffolk and North Essex FT, as their intensive care units were full.

It is not clear if both of these capacity issues are ongoing. All three trusts have been approached for comment.

Internal data seen by HSJ confirms particular pressure on the intensive care units at Southend hospital operated by Mid and South Essex FT and, also, at Queen Elizabeth Hospital King’s Lynn in north Norfolk.

HSJ understands that Southend hospital, part of the MSE trust, has a “particular problem” with discharging patients as the area is much more reliant on smaller family run care homes, many of which have closed down since the first wave due to a lack of residents.

Other areas are facing increasing delays in discharging patients due to a change in the process introduced by the Department of Health and Social Care. 

One senior leader in the region warned that elective operations are now likely to be delayed as the region’s healthcare systems reach a tipping point on capacity.

They said that some areas, such as in Basildon, have seen steep increases but that others are experiencing a “sustained moderate level of coronavirus cases which is leading to sustained pressures”.

They added the region is struggling with increased length of stay from covid patients (as more people are surviving than in the first wave due to better treatments), a complex discharge system and a collapsing social care market in parts of the region which is creating a “perfect storm” of pressures.

They said: “Typically we are normally quieter in the weeks before Christmas but everyone is saying it feels like January workload in December. All sustainability and transformation partnerships in the area are pretty full and it wouldn’t take a great deal more to tip our systems over.

“I don’t think anyone will formally say they are standing down elective work but we are all looking at priority 3 and priority 4 patients and now asking ourselves if they can wait a bit longer. Looking at the growing infections rates in the community, within two weeks this is going to be our new norm.”

NHS England has categorised elective work into different levels of priority dependent on how quickly patients must be treated before they experience clinical harm. P3 patients are those that are seen as needing an operation within three months or less. P4 refers to people who doctors feel can wait more than three months.

NHS England was approached for comment.

The East of England region covers six STPs/ICS: Cambridgeshire and Peterborough; Mid South Essex; Norfolk and Waveney; Suffolk and North East Essex; Bedfordshire, Luton and Milton Keynes; Hertfordshire and West Essex.

Updated on 14.20 on 17 December 2020 to clarify the position at the Royal Papworth FT.