CORONAVIRUS patients could be selected for treatment by a “lottery” system in the event the health service is overwhelmed by cases.
Emergency protocol guidance sent to specialists across the NHS states that “fair decisions” will need to be made “in times of inadequate resources”.
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The draft triage document is intended as a “practical guide” for clinicians on how patients should be selected if there are insufficient resources available.
It provides a step-by-step procedure for ranking patients on an “ethical system” and eventually getting them through to the treatment stage.
A four stage process has been set out for health care workers, with the first step being a health assessment which will take into consideration comorbidities such as alcoholism and how likely it is a patient will survive.
It will also include the views of both the patient and the family and consideration of ethical factors – such as saving those who have more years of life to live.
A final check will be given by a clinician that had not previously been involved in a patient’s treatment.
The document, seen by The Telegraph states: “In summary, assess which treatment options are likely to provide meaningful benefit, discuss those options with patient and family/carers to obtain their views on the benefits and burdens of each option, discuss the ethics of the wider situation and combine this in an overall clinician judgement.
“For patients with similar prognosis, who cannot be separated in other ways, a random allocation, such as a lottery, may be used.”
Pressure on the NHS is mounting and the new guidance on patient treatment comes after the health service was pushed into the highest level 5 for the first time.
Under the red level five alert, there is a “material risk” of hospitals being overwhelmed within weeks and stricter social distancing measures being put in place.
The pressure on the NHS is in part due to the coronavirus pandemic.
It was last night revealed that one in fifty people now have Covid – more than one million Brits.
Cases have soared by 70 per cent in just one week – and are now up by 60,916, as of Tuesday evening.
In England alone, some 27,000 people are in hospital with Covid, 40 per cent more than during the first peak in April.
There is not yet any official guidance on how treatment should be allocated to patients seeking it from the NHS and the document was originally published in the Journal for Medical Ethics.
The draft has been described as a “research document” which is solely intended for discussions around treatment.
One NHS doctor told The Telegraph that there was an “urgent need” for the Department of Health and Social Care to release guidance to NHS Trusts.
Dr Moosa Qureshi said he was appalled that individual NHS Trusts were having to draw up their own guidelines.
He said: “Ad hoc policy-making driven by clinical teams within individual NHS Trusts – no matter how good – is the inevitable response to lack of leadership at a national level, but will lead to inconsistency, inefficiency and large numbers of avoidable deaths.”
Earlier this week it was revealed that Brits would be in a postcode lottery when it comes to coronavirus vaccines as one in four people live in an area where there are no vaccination centres.
A total of 697 vaccine centres have so far been set up in hospitals, GP surgeries, and public buildings across England.
But NHS England data shows that 13million of England’s 56million population live in a constituency where no site has yet been set up.
Among the towns without any centres ready are Bedford, Newark, and Braintree.
Nottingham, with a population of around 330,000, has only one.
London, where seven-day infections rates are currently around double the national average, has just eight sites for every one million people – a lower level than any other area in the country.
The analysis also found that eight million people in England had to travel ten miles or more to reach their nearest site.
For an additional 1.7million, the distance is 20 miles or more.
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The document – intended to be used as guidance also proposes that people who participate in research to improve treatments or “vaccines during an epidemic should be given some priority for treatment”.
Under this guidance people who had helped trial the Oxford/AstraZeneca jab earlier this year would be given priority over others.
In a statement the NHS said: “The NHS has been clear that no patient who could benefit from treatment should be denied it and, thanks to the hard work of nurses, doctors and countless others in creating surge capacity and hospitals working together and that has not happened.
“However, it is vital that we cut the spread of the virus and everyone can play their part by following the advice on ‘hands, face, space’ and staying at home.”