• NHSE can now take command of all NHS resources after declaring national incident
  • All NHS organisations told to establish single point of contact on coronavirus response, available 24/7
  • NHS organisations also reminded not to stockpile

NHS bosses have declared coronavirus as a “level 4 incident” — a move which allows NHS England to take command of all NHS resources across England.

The escalation to the NHS’ highest risk rating was made public in a letter sent today by NHS England and Improvement strategic incident director Keith Willett and incident director Stephen Groves.

The move, taken a month ago, allows NHSE’s national team to direct all health service resources in England through its regional teams, according to NHSE’s Emergency Preparedness, Resilience and Response Framework.

The letter also set out a series of orders for local NHS organisations in preparation for the virus — including setting up incident management teams operating 24/7 and warning acute providers they should expect to soon be called on to treat covid-19 cases in general units.

The letter said: “To date, covid-19 has been managed as a high consequence infectious disease through our specialist centres so we could learn as much as possible about the virus and course of the illness.

“It is now appropriate to begin to manage some patients within wider infectious disease units and, in due course if the number of cases continues to grow, we will need to use all acute units, for example through the cohorting of patients.”

Acute trusts were also instructed to review all pathways, particularly those dealing with respiratory illnesses, and “consider the impact that a possible surge in medical patients might have on services and stocks”.

“These stocks are being monitored daily, with additional stock being ordered where necessary,” the letter added.

The letter said acute providers should identify how they would segregate areas, review critical care and high dependency capacity, and consider implementing alternative models, such as remote consultations, where possible.

Organisations were also instructed not to stockpile medicines, devices or consumables “as this may put a strain on the supply chain and exacerbate any potential shortages”.

All organisations including trusts, clinical commissioning groups and sustainability and transformation partnerships/integrated care systems were told to establish a single point of contact, to be available 24/7, for receiving and acting on all covid-19 patient management, alerts, referrals and tracking.

Organisations were also told staff “including bank staff and subcontractors, who [have] to be physically present at an NHS facility to carry out their duties” should receive full pay for any period they are required to self-isolate.

The letter added NHS organisations should work with “social care partners” to make sure they are ready to manage residents who had been affected by the outbreak.

The letter followed the government today setting out its action plan to address the outbreak. It comes as the number of covid-19 cases in the UK rose from 39 to 51.

NHSE/I has also established a national incident management team with the Department of Health and Social Care and Public Health England and an operational incident coordination centre, available seven days a week.