Trust becomes first to see half its beds occupied by covid patients during second wave

Fifty-two per cent of Medway Foundation Trust’s beds were occupied by covid patients on Monday 30 November, among the highest proportions recorded by any trust during the covid pandemic.

The trust’s seven-day rolling average in the week to 1 December was 45 per cent, the highest level for any trust during the second wave. During the previous week — to 24 November — the trust had under 30 per cent of its beds occupied by covid patients.

Rising numbers of covid cases have caused major issues for the trust in the last few weeks, including long delays for ambulance handovers as its emergency department staff struggled to create enough space to take in more patients and find beds for people who needed to be admitted. A large number of its staff have also needed to self-isolate, as family members have contracted covid in the community.

However, HSJ understands the trust has managed to continue with urgent electives and cancer procedures, although some routine elective operations have been postponed.

The trust has struggled with keeping general and acute beds open. NHS England data states it had 468 general and acute beds available on 23 November but, by 29 November, this had fallen to 429 with 405 occupied. With the need to separate covid and non-covid patients, as well as keeping wards single sex, this is likely to have meant the trust was close to 100 per cent capacity. Its 28-bed intensive care unit department was also nearly full for much of the week.

Some of the pressures have started to ease in the last two or three days but staff are said to be “shattered”.

In the seven days to 28 November, the trust had 43 covid-related deaths  — a 48 per cent increase on the previous week and only two lower than its peak of 45 in the first wave of covid. Nearly all the eight trusts with more deaths than Medway during this period were significantly larger than Medway, which has an income of around £300m.

Medway FT has also had high levels of hospital-acquired covid  — 42 cases in the week to 29 November  — compared to 131 which were community acquired.

The Kent and Medway Sustainability and Transformation Partnership had 98 deaths in the same period, a 51 per cent increase. It is the only STP or integrated care system where deaths are still rising steeply.

The hospital takes most of its patients from the Medway Council and Swale Borough Council areas. Public Health England data up to 28 November shows Swale has the highest rate of covid cases in the country at 566 per 100,000. Medway is the third highest at 531 per 100,000, which is equal to 1,480 cases in total. Both areas have significant deprivation. Nearby Gravesham was fifth, while three other Kent areas are in the 10 areas with the highest rates.

This is likely to make it harder for Medway FT to call for help from other trusts. The nearest alternative hospitals are Darent Valley Hospital in Dartford — which serves Gravesham — and Maidstone Hospital. The Maidstone area has also had rapidly rising rates of infection.

Next week, Medway Council is launching mass testing of asymptomatic people in an attempt to identify cases in the community and get them to self-isolate.