areas for suspected coronavirus patients.
Suggestions from the health secretary Matt Hancock that the NHS would use “home ventilation kits”, and
that an extra 5,000 intensive care beds could be created, were labelled “fanciful” by the chair of the British
Association of Critical Care Nurses today.
Nicki Credland said: “If you already have a system running at 100 per cent capacity, the idea you can get a
significant amount of additional beds is just not realistic. There simply aren’t enough beds for them. We will
need to make difficult decisions about which patients are going to be admitted to intensive care.
“The general public have a right to the truth.”
“It will be a real ethical dilemma for staff. We will need to make difficult decisions about which patients are
going to be admitted to intensive care.”
She added: “I don’t know what Matt Hancock meant by home ventilation. It isn’t possible for people who
are acutely unwell.”
One A&E doctor in the east of England said their hospital had already run out of protective respirators,
adding: “On Monday the hospital was full, all escalation areas fully bedded down and patients waiting over
12 hours in A&E for admission. And this is before we’ve even contemplated dealing with a single
coronavirus case.”
He added there was a “genuine apprehension about how unprepared we are. The NHS is so strained at the
moment it wouldn’t take many cases to seriously compromise our ability to deliver safe care. Even if fears
about potential case numbers are massively overblown it really wouldn’t take very many cases needing
hospital treatment to have the system crumbling.”
A medic at the Royal Lancaster Infirmary shared an alert to staff there on Tuesday that said the hospital was
short of 63 beds at 8.30am with 11 patients waiting in A&E, two intensive care patients in recovery areas
[instead of a ward] and eight patients to be admitted for surgery. The messages urged doctors to “expedite
discharges as a priority”.
The medic said: “This is not particularly unusual to be honest.”
The president of the Intensive Care Society, Dr Ganesh Suntharalingam, told The Independent there was a
potential for “disparity” between hospitals in their ability to expand critical care services with larger units
better able to weather any impact.
He said: “If demand increases dramatically, we will all have to use other hospital areas and resources in
atypical ways. Staffing is an issue and, as in any major incident, staff from different teams may need to work
together to deliver the best care possible”
He said it was important that regional and national systems were in place to coordinate efforts, with
hospitals working together in the event of an outbreak “so that no patient is ever denied the right care when
there is a single bed left anywhere in the country. We are very clear that the decisions of who to admit must
remain ethical and equitable as always.”
A consultant at the University Hospitals of Nottingham Trust said the hospital had declared an internal
incident on Tuesday this week with 130 patients in A&E and 40 waiting for a bed. He added sarcastically:
“We are fantastically well prepared for coronavirus.”
One manager in the northwest said face masks and other equipment were starting to be rationed due to
concerns over a lack of supply.
An intensive care doctor from London added: “There’s no denying we are very full indeed. It’s essentially a
‘one in, one out’ kind of mentality.