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Hospitals and the ambulance service in London are likely to become overwhelmed from covid in the next two to three weeks, a leaked document reveals.

It also said parts of the service in the capital would struggle to deliver virtual wards, a key component of the NHS’ response to the omicron wave.

The news comes two days after the mayor of London declared a major incident in the capital, the first time he has done so since January this year, near the height of the winter 2020-2021 wave. 

The leaked document from NHS England London, seen by HSJ, said: “NHS services in London are again facing significant operational pressure as a result of the current surge in covid-19 cases from the new variant of concern, omicron.

“Through recent modelling, it is predicted that the London Ambulance Service (LAS), Emergency Departments (EDs) and the General and Acute (G&A) bed base are likely to become overwhelmed due to rising covid demand in the next 2-3 weeks.”

Put your money where your guidance is

NHS England has been told that “pushing guidance” without the resources to back it up is “unhelpful”.

Feedback from workshops hosted by NHSE’s Emergency Care Improvement Support Team given by London clinical leaders at the start of the month has been seen by HSJ.

ECIST were told that “more pushing of the guidance without the practical resources to implement it” is among the things they “wouldn’t find helpful right now”, along with “requests for reporting, data and evidence at short notice” and “more paperwork or forms”.

It is unclear whether the comment about resources refers to social care or NHS funding or staffing. But the comment was made after NHSE has issued “guidance” on “immediately stopp[ing]” all ambulance handover delays back in October, and last week told trusts to discharge at least half of their medically fit patients to free up resources ahead of the omicron surge.

Clinical leaders also said “inefficient processes” and risk averse approaches within trusts are among the biggest challenges in reducing patients’ length of stay.