Two hospitals ‘decanting’ to central London trust amid ‘extreme’ pressures

A coronavirus briefing to staff at Guy’s and St Thomas’ Foundation Trust sent today, seen by HSJ, has described “extreme pressure” across its wards, critical care and “all London hospitals”.

It also said there was a request from NHS England and NHS Improvement’s London region to increase critical care capacity, or “super surge”, as bed occupancy rates remain high.

The central London trust is providing “mutual aid” to neighbouring providers in south east London, the correspondence added, which includes “decanting” patients from Queen Elizabeth Hospital (in Greenwich) and King’s Collge Hospital (in Denmark Hill). They are overseen by Lewisham and Greenwich Trust and King’s College Hospital Foundation Trust respectively.

It is unclear whether it refers to all patients or specific cohorts, and whether they are going to both Guy’s and St Thomas’ hospitals.

Another element of the mutual aid described is an “intermittent” London Ambulance Service divert “from several hospitals”, which is being reviewed every 12 hours. It appears this would see emergency patients from further south east in London diverted to St Thomas’.

London trusts have adapted rapidly to covid demand amid severe pressure. Barts Health Trust, one of the largest providers in the country, has announced the sickest covid patients, alongside emergency care and trauma admissions, will be seen at the nearby Royal London Hospital so others in the area can have some “breathing space”.

Meanwhile, the Royal National Orthopaedic Hospital, a leading specialist site in the centre of the capital, has cancelled a lot of routine elective care so it can take on acute patients from nearly hospitals which have been overwhlemed by covid. It said it would continue providing urgent surgery for specialist tertiary patients, and provide services to its patients with cancer and spinal cord injuries.

A GSTT spokesman told HSJ: “In common with hospitals across London, we are extremely busy. We have a surge plan in place, opening more beds and capacity, to meet increasing demand and declared a critical site incident last week to help us implement this plan.”

The NHS in London said in a statement: “The NHS in London is under sustained pressure and is using a range of scenarios to plan how many staffed equipped beds are needed to meet demand, with hundreds of beds already created in all of our acute hospitals thanks to the extraordinary efforts of our staff.

“Arrangements are reviewed several times a day with patients transferred between hospitals where necessary.”

A LGT spokeswoman told HSJ both GSTT and KCHFT have “significantly more” ICU beds than it does, and that there is an agreement in place to transfer patients to both providers once they reach capacity in their own.

The statement added: “This is recommended practice in all critical care networks and is subject to regular reviews.”

KCHFT has been approached for comment.

UPDATE, 15.50: This article has been updated to include comments from LGT and the NHS in London