- Medical director warns the capital’s acutes are “creaking” under covid and non-covid pressures
- Covid bed occupancy in North London has reached around 9 per cent
- Staffing pressures in key roles mean high tempo on electives may falter
Trusts are ‘creaking’ across London as they address the latest surge of covid patients and mounting non-covid activity, according to a medical director at a major London trust.
Professor Geoff Bellingan, medical director for surgery and cancer at University College London Hospitals Foundation Trust, told a board meeting this week: “We are creaking across London, we’re already [doing] inter-sector transfers for critical care and I would be most surprised [if] we’re not cancelling more elective surgery next week.”
Professor Bellingan warned the trust may have to close operating theatres despite the decline in covid cases in the community.
Providers are facing considerable challenges in the coming months. They must address growing numbers of covid patients, mounting referrals from stretched GPs, and increasingly busy emergency pathways while also tackling cancer and elective backlogs that built up during past covid waves.
Most of the patients in UCLH’s ICU are unvaccinated, according to the papers for its July board meeting.
The number of beds occupied by covid patients in the North London health system has grown to more than 200 in recent days, which is about 9 per cent of the general and acute bed base. However, this is still far below a peak in January of around 1,200, which was more than half the bed base.
HSJ revealed this week that Whittington Health Trust was one of eight trusts that had at least one in 10 of their general and acutes beds occupied by covid patients.
Anaesthesia has been a key pinch point for trusts nationwide when tackling successive waves of covid, as there are not enough anaesthetists to both staff ICUs full of covid patients and operating theatres running elective lists. UCLH is already 14 anaesthetists below establishment and “summer holiday leave will only add to the staffing risk”, the trust’s board papers warned.
A&E in the capital is also under pressure.
Lesley Watts, chief executive of the North West London Integrated Care System, told a meeting of the NWL Clinical Commissioning Group on Thursday that the system was running at “winter levels of emergency demand”.
She said the ICS was exploring expanding “see and treat”, which encourages paramedics to care for patients at the scene where possible rather than take them to hospital. The work will be shared with London Ambulance Service.
She gave the example of “patients who are transferred to hospital but might not need to be admitted. Maybe they just need some fluids, especially if they are brought from nursing homes or care homes”.
Source
Trust board meeting, papers
Source date
July 2021
Topics
- CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST
- Lesley Watts
- London
- London Ambulance Service NHS Trust
- NHS North Central London CCG
- North Central London ICS
- NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST
- Performance
- Royal Free London NHS Foundation Trust
- UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST
- Whittington Health NHS Trust
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