NHS will move to highest alert level from midnight as PM warns Covid poses an ‘existential threat’


THE NHS will move to its highest alert level from midnight as Covid poses an “existential threat”.

Boris Johnson once again warned people could be “turned away” from hospitals if the health service is over-run with coronavirus cases.

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Sir Simon Stevens today warned that sick Covid patients are filling up NHS hospitals

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Sir Simon Stevens today warned that sick Covid patients are filling up NHS hospitalsCredit: PA:Press Association

Ahead of today’s vote on the second national lockdown, the Prime Minister told MPs: “Be in no doubt what that means for our country and for our society.

“It means that the precious principle of care for everyone who needs it, whoever they are, whenever they need it, that principle could be shattered for the first time in our experience.

“It means those who are sick and suffering and in need of help could be turned away because there was no room in our hospitals.

“Doctors and nurses could be forced to make impossible choices about which patients who live and die. Who would get oxygen and who couldn’t.”

Hospitals are filling up

Mr Johnson’s fears were echoed by NHS chief exec Sir Simon Stevens earlier today, when he told journalists that the NHS is facing a “serious situation” over the coming winter months.

Sir Simon warned that across England, hospitals are filling up with “desperately sick” Covid patients – adding that we are close to seeing a situation worse than the first peak.

Speaking this morning at an NHS England and NHS Improvement press conference, he revealed that the level would be moved from three to four – the highest alert level.

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Level 4 is an incident that requires NHS England and National Command and Control to support the NHS response. It requires the NHS to coordinate its response in collaboration with local commissioners.

Sir Simon said: “The level had to be that at the end of January and at the back end of June.

“It’s not a situation anyone wants to be in”, he added.

This is different to the Covid alert level which was moved from level 3 to level 4 back in September.

Level 3 means that the Covid virus is in general circulation, and level 4 means that transmission is high or rising exponentially.

The graph above was shown during the conference today and it details the number of people in inpatient beds in England from August 1. The graph below is a projected model of what bed usage could be by next month
The graph above was shown during the conference today and it details the number of people in inpatient beds in England from August 1. The graph below is a projected model of what bed usage could be by next monthCredit: NHS England
Credit: nhs england

Winter is coming

Stephen Powis, medical director at NHS England said hospitals across the country are already at the point where they are “very busy” adding, “we are still in autumn”.

Prof Powis was appearing alongside Sir Simon and Dr Alison Pittard, consultant in intensive care medicine and Dean, faculty of intensive care medicine NHS chief executive.

He said: “It is not the case that hospitals are quiet – winter is coming.

“What I hear from NHS staff is anxiety going into winter, they know how hard they had to work in the first peak and there is a determination to get the job done.

“They get out of bed to treat people and help them recover. This won’t be a normal winter unless we all assist.”

Non-Covid patients could be turned away

The Prime Minister reiterated the point to MPs in the Commons this afternoon as the debate over the second national lockdown got underway.

“I know there are some members… who are hearing from their local hospitals that the pressure is not that great yet,” Mr Johnson said.

“But the whole point about a national health service is that when hospitals in one part of the country are over-run, sick patients are transferred to another until the whole system falls over.

“And let me be clear that his existential threat to our NHS comes not from focusing too much on coronavirus, as is sometimes asserted, but from not focusing enough.

“Because if we fail to get coronavirus under control it is the sheer weight of demand from Covid patients that would not only lead to the Covid casualties that I’ve described but which would deprive other patients of the care they need.

“We simply cannot reach the point where our NHS is no longer there for everyone.”

MPs are set to vote on a four-week second national lockdown this afternoon.

Mr Powis said he believes the situation in the NHS will continue to get worse unless “we act and all do what we are asked to”.

He added: “I believe the British people understand the need to do it. As we get into winter our staff will be busier.

The graph above shows the number on inpatients beds in England from August taken up by Covid-19 patients

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The graph above shows the number on inpatients beds in England from August taken up by Covid-19 patients Credit: nhs england

 

“Unless we can control and bend, the curve, it will move to surgical capacity and we will have to postpone routine surgeries.”

Earlier today Sir Simon told BBC Radio 4’s Today programme that there are currently 11,000 coronavirus patients in hospitals in England – equating to 22 hospitals’ worth of Covid patients.

Sir Simon said that there had been a “very substantial” increase in Covid-19 admissions in October.

He said the service will soon be able to “press go” on routine testing for all asymptomatic NHS staff and said that this is being rolled out in areas of the country with high case numbers.

With more NHS testing, the hope is that less people will end up in hospital and that the NHS will be able to continue to run smoothly.

Sir Simon said that at the beginning of September there had been just under 500 Covid patients in hospitals.

Referring to slides shown to the general public by scientific advisers on Saturday evening, he said the “facts speak for themselves”.

“We began early September with under 500 coronavirus patients in hospitals, by the beginning of October that had become 2,000, and as of today that is just under 11,000.

“So put another way and we’ve got 22 hospitals worth of coronavirus patients across England and indeed even since Saturday when the Prime Minister gave his press conference, we have filled another two hospitals full of severely ill coronavirus patients.”

The map on the left hand side shows the severity of cases at the start of November, the dark purple colour shows areas that had higher case loads of Covid-19. The map on the right shows how the virus spread over the month with the darker purple shade taking over more of the country

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The map on the left hand side shows the severity of cases at the start of November, the dark purple colour shows areas that had higher case loads of Covid-19. The map on the right shows how the virus spread over the month with the darker purple shade taking over more of the country

‘Face the reality’

He said that the “reality” of the situation is that the NHS has more Covid inpatients in hospital and in intensive care now, than during the first peak in April.

Sir Simon added: “These are desperately sick patients in hospitals.

“We are adding as much capacity as we can in anticipation of not only the coronavirus but the extra winter pressures that always come along at this time of year.

“The fact that the reason we want to try and minimise the number of coronavirus infections in patients is not only because of the excess death rate that implies but because of the knock on effect it has for other services, routine operations and cancer care.

“If we want to preserve those other services so that the health service can continue to help the full rage of patients – we need to do everything we can together to keep the infection rate down of the coronavirus.”

He added that modelling from the Scientific Pandemic Influenza Group on Modelling (SPI-M) shows that capacity will only continue to be stretched.

‘Minimise disruption’

The NHS chief said the health service did not run out of critical care capacity during the first wave – and added he hoped that would be the case over winter.

He said hospitals would be able to continue with local measures based on pressures faced at individual hospitals.

Sir Simon added that the whole of Europe is seeing the same issue with capacity and that countries such as France, Germany and Spain are all facing issues.

He said the NHS has “prepared carefully” for the second peak and claimed that the service wanted to “minimise the impact of the virus.

“We have 159 A&E departments that are getting upgrades so they can split their coronavirus patients from the rest.

“We are expanding critical care, we have got more testing and the government have stockpiled PPE for us.”

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