• Liverpool’s hospitals have begun scaling back their elective activity in response to rising covid admissions
  • Cancer and urgent procedures to be protected “where possible”
  • Comes as NHSE triggers testing of asymptomatic staff in the north and puts Nightingales on standby 
  • Non-specialist staff to be prepared for redeployment to critical care teams

Liverpool’s hospitals have begun scaling back their elective activity and preparing non-specialist staff to be redeployed to critical care teams, according to a memo seen by HSJ.

In a message to staff, chief executive Steve Warburton said Liverpool University Hospitals Foundation Trust has reached a “critical point” in terms of coronavirus pressure.

It is currently the most affected city by the virus, although pressure is high across large parts of the north of England. NHS England today said it was introducing routine testing of asymptomatic staff in the most affected areas, and that Nightingale hospitals in central Manchester, Sunderland, and Harrogate would be put on standby.

The Liverpool trust currently has around 250 beds occupied by patients with covid-19, which represents around 15 per cent of the bed base. This is thought to be the highest proportion among major acute trusts in England.

On Friday, HSJ revealed urgent talks were being held with NHS England and system leaders about how the trust should respond.

The memo, sent after those meetings, said the trust was “taking a phased approach to reducing our elective programme, while exploring options with other providers to maintain some of this work in alternative locations”.

It added: “We will continue to prioritise surgery based on clinical need with a view to maintaining urgent and cancer surgery where possible.

“We will continue to maintain access to outpatient appointments wherever possible and maintain diagnostic activity.

“We recognise that this will be distressing for patients whose elective care needs to be rescheduled, however we must always ensure that the care we provide is safe.

“We understand that this is a very challenging time for staff and we will be sharing more information about the enhanced support we have in place for you in the coming days.”

Mr Warburton said the trust has restarted training for staff in preparation for additional critical care and CPAP demand, while appropriate streaming processes will be implemented.

As previously reported, Liverpool has had high covid transmission rates in the community for several weeks, followed by a surge in hospital admissions over the last fortnight.

Staff at the trust told HSJ they support the measures, but said it will be difficult to move care to other sites.

One senior clinician said: “Most clinicians support this approach as we can’t see another way to do things.

“Ideally we would have clean hospitals to carry on elective work, but the issues with that are staffing them and also ensuring that any staff and patients are actually not infectious when the prevalence is so high in the community.”

There are also increasing concerns about other parts of Merseyside and the wider north west region, while leaked modelling data has suggested Lancashire could be on course for almost 500 covid deaths in hospitals over the next five weeks.

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