• Senior nurses told in closed briefing to plan for “seven-fold” increase in intensive care capacity, according to sources present 
  • NHSE denies seven-fold is the objective, but says capacity should more than double, increasing by several times
  • Should begin to treat coronavirus like the flu — not isolating all acute patients

Hospitals should be planning for a massive increase in intensive care capacity to prepare for coronavirus, according to the person leading the NHS’ covid-19 response.

HSJ understands Keith Willett, NHS England strategic incident director, made the comment while speaking to a conference of chief nurses from local trusts today.

Sources present said he said an increase of up to “seven-fold” was potentially needed, but Professor Willett has later insisted he said “several”. NHSE said it was aiming to more than double the critical care capacity, but did not want to be more specific.

There are currently about 4,000 adult critical care beds open, implying the requirement is for an increase to around 28,000. The health secretary has previously indicated the NHS could open a further 5,000 critical care beds, but it is unclear how.

Local NHS leaders have reported in recent days being asked to identify how much extra intensive care capacity they can open, HSJ has been told, as well as concerns about the difficulty of reaching the level needed.

According to sources, Professor Willett indicated to the chief nursing officer’s summit that preparing for a covid-19 surge would mean relaxing normal ratios of critical care staff to patients, and discharging more patients. The service was likely to soon begin cancelling non-urgent planned care, he indicated, and said the NHS nationally is seeking to buy necessary equipment internationally.

In a statement subsequent to the event, Professor Willett said he “did not say a seven-fold increase, I said a several-fold increase”.

The former surgeon, who is now part of NHSE’s senior medical team, also told the meeting that hospitals should shortly move to cease trying to isolate coronavirus patients in separate rooms when they attend or are admitted, and instead simply seek to keep their beds sufficient space apart to prevent spread.

He said finding separate rooms for them all was not realistic, and indicated the health system instead needed to begin treating covid-19 patients like it would normal flu patients, sources said.

They should keep space between beds and enforce hand washing, and wearing the necessary masks and gloves, Professor Willett said, according to sources.

The shift to a more widespread response also means defaulting to treating more covid-19 patients at home, Professor Willett told the meeting, HSJ was told.

Professor Willett said staff who had been exposed to covid-19 infected patients should continue to work unless and until they have symptoms, at which point they should stay at home.

He also referred at the meeting, taking place in Birmingham today and tomorrow, to government plans for changing legislation to give the NHS short-term freedoms to tackle the spread of coronavirus.

11 March 7.30pm: Updated to reflect NHSE’s subsequent statement.