Some hospitals in the north of England are set to run out of beds for Covid patients within a week, health chiefs are warning, amid growing signs that the disease’s fast-unfolding second wave will seriously disrupt normal NHS care for a second time.
NHS trusts in the north-east and north-west are getting so many new Covid cases every day that some are already planning to ditch routine surgery again to free up staff and beds, despite a health service-wide diktat that they should continue to provide normal care this time round.
“Mutual aid” plans are also being laid for hospitals to take Covid cases from outside their area to help relieve the pressure on those in which all beds equipped to treat such patients have filled up.
Matt Ashton, Liverpool’s director of public health, told the Guardian that the city’s two main acute hospital trusts are admitting so many new Covid patients every day that they may reach their maximum capacity by the end of next week.
“I don’t want to panic people but within seven to ten days our hospitals will be at the level they were at the peak of the pandemic.”
In a meeting chaired by England’s chief medical officer, Chris Whitty, on Thursday, MPs from the north and the Midlands were warned that some hospitals there could see even more Covid patients in intensive care units than during the spring peak within 22 days if no further action was taken.
Ashton said: “If the north-west capacity is likely to be reached in 22 days, we will get there first – Liverpool will get there first.”
The number of Covid patients being treated by the city’s Royal Liverpool and Broadgreen trust and Aintree University Hospital NHS trust has soared from 100 to 200 in the last week. The two trusts have about 400 beds between them which are suitable for caring for such cases. The fact that hospitalisations are doubling every seven days means they could reach their limits of 400 very soon, especially as Liverpool now has one of the highest infection rates in England, added Ashton.
“It’s doubled in a week in effect from roughly 100 to roughly 200. That’s hugely worrying,” said Ashton, adding that on current trends another doubling would see all 400 beds full by late next week. “Beds will fill up quickly now. This is the point where the NHS will start to struggle in doing its normal routine business alongside its Covid business.”
MPs who were briefed by Whitty and health minster Edward Argar believe that the government is preparing to impose further new restrictions on northern England, aimed at curbing the spread of infections, despite many of the local lockdowns already in force having failed to achieve that.
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Chris Hopson, the chief executive of NHS Providers, which represents trusts, agreed the rapid rise in hospitalisations in the north meant some hospitals may soon reach their limit.
“Trust leaders in the north-west, Yorkshire and north-east are telling us they are extremely concerned about the rapidly rising levels of Covid-related hospital admissions. For a few trusts, admission levels are now at their highest since Covid-19 arrived in the UK,” he told the Guardian.
“For some hospitals, the number of Covid patients being admitted means there is a danger they could reach capacity within as little as a week or two. They would then have to look for support from neighbouring trusts.”
Matt Hancock, the health secretary, underlined the government’s deep unease about the situation when talking to hundreds of NHS bosses at a virtual NHS Providers conference on Thursday.
“We’re at a perilous moment in the course of this pandemic. I’m very worried about the growth in the number of cases, especially in the north-west and north-east of England, parts of Wales, Scotland and Northern Ireland, [and] parts of Yorkshire,” Hancock said.
The number of Covid patients in hospitals across the north-east and north Cumbria has jumped fivefold in the space of just three weeks, from 60 in mid-September to 300 now. Similarly, from having no new Covid patients being admitted in ICU in mid-September, they now have 50 such cases.
Hospital sources in the north-east say that the speed of these recent increases means that, even though they can deal with as many as 1,000 Covid patients, they may be forced to start cancelling planned surgery again within days. The move is being considered as a way of freeing up beds and staff for Covid patients, in a repeat of the action all trusts took during March and April.
One hospital boss said: “We aren’t too far away from having to postpone elective operations. I suspect we’ll have to do that in the next week, or even sooner.” Some of those affected could be patients who have already been waiting many months for surgery, since hospitals across England postponed operations such as joint replacements and cataract removals in the first wave.
Prof Chris Gray, the clinical lead for the NHS’s north-east and north Cumbria integrated care system, said: “Covid-19 certainly hasn’t gone away and our hospitals are now starting to feel the impact of the significant rise in cases across our local communities. We are well prepared for this and the current numbers are well below what we experienced at the height of wave one.
“The big challenge for the NHS now is how we manage the continued uncertainties of Covid-19 as we head into the pressures of winter and continue to recover our elective programmes of planned care in the months ahead.”
In March NHS England told hospitals to cancel most normal care apart from cancer surgery and emergency operations. As a result millions of patients were unable to have a diagnostic test, be screened for diseases such as cancer and have non-urgent surgery, such as a hernia repair or joint repair.
However, that policy has produced a major backlash, with medical groups, health charities and MPs on the Commons health select committee warning that potentially tens of thousands of patients could die from cancer and other diseases because their illness are not spotted or treated. NHS England has told all trusts to keep normal care going during the second wave, but hospital chiefs privately doubt that they will be able to do so.
Greater Manchester is seeing a much less dramatic rise in cases than in Liverpool. The number of Covid patients in intensive care across the region has only risen from 45 to 47 over the last week, although the number of Covid sufferers being treated on wards has increased more sharply, from 226 to 293.
NHS data shows that, in the week to 5 October, 61% of reported Covid admissions and in-hospital diagnoses in England were in the north-west, north-east and Yorkshire.
In the week to 1 October, although the total proportion of occupied hospital beds taken up by Covid patients stood at just 1.7% nationally, 12% of the beds in Tameside hospital in Manchester were taken up with the disease, as were 11.5% at the South Tees trust in the north-east. All ten trusts with the highest proportion of beds occupied with Covid patients were in the north-west, north-east and Yorkshire.
Additional reporting by Pamela Duncan and Haroon Siddique