Confusion over hospital’s ‘critical incident’

Medway Foundation Trust was understood to have declared the incident after a difficult weekend was followed by an even more challenging Monday. But at lunchtime on Wednesday, nearly 24 hours after being notified of HSJ’s understanding, it issued a statement from chief executive James Devine saying no “official critical incident” had been declared. 

 “While we are seeing an increase in demand for our services due to an increase in coronavirus patients, we are working with NHS partners across Kent and Medway to maintain services for our patients and will continue to review our approach,” he said. 

However,NHS staff have continued to contact HSJ with concerns about how the trust was coping.  One source told HSJ the pressure within the hospital was at levels not seen before. Another spoke of staff members being in tears amid long delays for ambulance handovers. 

HSJ understands Medway is close to full capacity and on Tuesday had around 110 confirmed covid patients — about a fifth of its normal bed base and approaching its wave one figure of about 130 — following a steep rise in recent weeks.

Last week HSJ reported that the trust was struggling with 90 covid patients and ambulances had had to wait up to five hours to hand over patients.

Flow through the hospital has been impacted as the trust has struggled to discharge people. It appears to be an extreme version of operational pressures beginning to affect hospitals around the country, as covid combines with seasonal pressures, while trusts seek to maintain elective care.

While most of the South East has not been severely affected by the covid this autumn, Medway has had 25 confirmed covid deaths in the seven days to 14 November. In the seven days to 14 October it had just two deaths.

In the seven days to 14 November, the hospital had the highest number of inpatient covid deaths of any trust in the the South East region, and second highest (after Barking Havering and Redbridge University Hospitals Trust) outside the North West, North East and Midlands areas, which have been the focus for the autumn covid outbreaks.

As well as covid admissions from the community, the trust has seen cases apparently caught within the hospital too.

Kent and Medway local authority areas have seen a significant increase in covid cases in the last 10 days and Kent County Council has confirmed it is requesting supplies of rapid testing kits. Although it has not said where they could be used for mass testing, Thanet and Swale have both seen high numbers of covid cases. Data issued on 12 November but covering the period from 29 October to 4 November showed Swale – which is served by Medway FT — had the highest rate in the South East at 240 cases per week for each 100,000 people. Thanet had 224.

Update: 18 November 3pm. Mr Devive’s comments added, aalong with additional comments from NHS staff.