The must-read stories and debate in health policy and leadership.
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- Today’s watchful eye: CQC considers remote monitoring for troubled trusts during covid-19 crisis
The results from HSJ’s exclusive snap survey of trust chief executives laid bare the challenges the NHS is facing as it gears up for (hopefully) a once in a lifetime battle.
The three biggest areas were staff testing, workforce shortages and running out of personal protective equipment.
The poll also suggested local leaders were overall largely supportive of the national response to the crisis, with around two-thirds of respondents stating they were satisfied with the guidance to date. Chiefs praised both the “impressive pace and detail of the advice”. However, some reported receiving sometimes confusing and challenging instructions from the centre with a lack of support or explanation.
Meanwhile, 13 of the 22 trust chief executives running organisations with ICUs warned they would run out of intensive care capacity by next week as the number of coronavirus cases continue to rise.
The need to dramatically increase the number of critical care beds and ventilator machines to cope with a surge in covid-19 patients has been well aired over recent weeks.
Less talked about is how the NHS is going to get adequate numbers of additional doctors and nurses to staff the new units.
The answer, which was revealed first to trusts in London, is to dilute the numbers of trained critical care staff looking after each patient.
HSJ understands trusts in the capital have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants.
Under guidance from the Care Quality Commission which applies at normal times, intensive care “requires a registered nurse/patient ratio of a minimum 1:1”.
Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”.
And, earlier this week, NHSX announced £500,000 of funding to be shared between start-up companies which can produce new technology to support people who are self-isolating due to coronavirus. One of the key requirements of the scheme — named Techforce 19 — was that the innovations can be scaled “within weeks” to aid the coronavirus response.
However, some health tech companies were sceptical about both the amount of money on offer (not a lot to go around a lot of schemes) and the timeframe for scale (felt to be overly ambitious). The Department of Health and Social Care stressed funding will only be awarded to ideas that can be easily rolled out and do not require any connectivity with NHS or social care systems.