Hospitals in Leeds and Edinburgh have been forced to cancel non-urgent operations in order to make room for coronavirus patients, it was revealed today.
Leeds Teaching Hospitals — one of the biggest NHS trusts in England — said it now has more Covid-19 patients in its wards than it did during the peak of the first wave of the crisis in the spring.
The trust, which runs five hospitals in the city, will start to cancel routine surgeries from tomorrow so it can make space for infected patients. Only essential ops will be going ahead in most cases, with planned procedures completely halted at the trust’s Chapel Allerton Hospital.
Covid-19 hospital admissions have soared by over 70 per cent in Leeds in the last week, local health chiefs claim. The rate of infection among people over 60 has also risen by more than two-thirds in the past seven days.
Meanwhile, the Royal Infirmary of Edinburgh has also had to postpone routine care, following in the footsteps of other badly-hit NHS hospitals in Bradford, Birmingham, Liverpool, Nottingham and several other parts of the UK.
Hospital bosses said 37 different types of elective treatments had been postponed at this stage to help ‘manage capacity’ — but they did not explain what the procedures were, or if cancer patients would be affected by the drastic decision.
The situation is beginning to mirror that of the spring, when thousands of non-urgent NHS treatments were cancelled in a last-ditch attempt to make room for a predicted wave of Covid-19 patients. However, the health service never became overwhelmed and now has to cope with a backlog of 2million patients whose treatment has been delayed.
It comes after the Royal College of Surgeons’ president today warned cancellations are ‘only going to happen more’ as the second wave of Covid-19 continues to grow.
Leeds Teaching Hospitals – one of the biggest NHS trusts in England – said it now has more Covid-19 patients in its wards than at the peak of the first wave of the crisis. Planned procedures have been completely halted at the trust’s Chapel Allerton Hospital (shown)
The Royal Infirmary of Edinburgh (pictured) is the latest in a string of hospitals across the UK which has had to stop non-Covid care
Leeds Teaching Hospitals Trust — the fourth largest in England in terms of total beds — has also began to start closing its theatres to make more room in ICUs, according to the Health Service Journal. Health bosses said they expect this to go on for at least a week.
A leaked internal document claimed the trust had 263 Covid-19 patients today, up from 148 recorded last Tuesday — a rise of 77 per cent. There are 25 infected people in intensive care.
Deputy chief medical officer at Leeds Teaching Hospitals David Berridge said: ‘These numbers are close to the peak seen in the first surge and prevalence data indicates that it may continue to rise for another one to two weeks.
‘Our current overall bed occupancy is far greater than in the first wave, so there is very significant pressure on our inpatient capacity.
Professor Neil Mortensen, president of the Royal College of Surgeons of England, said cancellations are ‘only going to happen more’ as the coronavirus ‘second wave’ grows
‘Unfortunately, as a result, we have had to cancel some operations and expect this to continue throughout the week due to pressures on beds in all areas of our hospitals.’
A spokeswoman for the trust said: ‘Not only is the number of Covid-19 cases increasing but so is the rate of increase. Local modelling based on prevalence data indicates that it may continue to rise for the next two weeks
‘The majority of admissions over the weekend has been older people with respiratory conditions. The infection rate for over-59s has increased from 165 per 100,000 last Saturday to 269 per 100,000.
‘We are standing down some planned operations due to current pressures which means that some patients will have their treatment postponed; only essential operations are going ahead in most cases.
‘We have stopped elective inpatient orthopaedics at Chapel Allerton completely and we have begun a rolling programme of theatre closures to increase critical care capacity.
‘We expect this to continue throughout the week, which means some difficult decisions as we prioritise cases of higher urgency. We are prioritising urgent treatments, including cancer operations.’
HOSPITALS THAT HAVE SUSPENDED NON-URGENT CARE
UNIVERSITY HOSPITALS PLYMOUTH
Non-critical planned surgery was temporarily paused at Derriford Hospital from October 13.
BELFAST HEALTH TRUST
The Northern Ireland trust cancelled all elective procedures in the week of October 12 to 16 to cope with a rise in Covid-19 patients.
BRADFORD TEACHING HOSPITALS
Some non-urgent surgery and face-to-face outpatient appointments were suspended in Bradford, from October 27 for two weeks.
MID YORKSHIRE HOSPITALS TRUST
Three operating theatres at Pinderfields Hospital in Wakefield were closed to enable staff to care for critically ill coronavirus patients, it was revealed on October 27.
LIVERPOOL UNIVERSITY TEACHING HOSPITALS
The Health Service Journal reported on October 12 that a memo to staff said the trust was ‘taking a phased approach to reducing our elective programme, while exploring options with other providers to maintain some of this work in alternative locations’.
UNIVERSITY HOSPITALS BIRMINGHAM
Patients told the BBC operations that were scheduled for as far back as September were scrapped.
Leaked emails on October 19, seen by The Independent, told surgeons to begin cancelling routine operations for some patients.
NOTTINGHAM UNIVERSITY HOSPITALS TRUST
Started shelving some operations after Covid-19 outbreaks on wards, according to a leaked memo seen by the Health Service Journal.
SWANSEA BAY HEALTH BOARD
All routine cardiac operations were cancelled at Morriston Hospital in the second week of October after a Covid-19 outbreak. Ten patients and five members of staff tested positive at the hospital.
HULL UNIVERSITY TEACHING HOSPITALS
The trust wrote to patients in the second week of October telling them it could be two years before their surgery or appointment.
Patients due to undergo the procedures at the Royal Infirmary of Edinburgh have also been contacted to say they have been temporarily halted.
The hospital — located on the outskirts of the city — is run by NHS Lothian, one of the 14 regions of NHS Scotland.
It provides healthcare services in the city itself, as well as East Lothian, Midlothian and West Lothian, where Covid-19 cases are higher than the rest of the country.
NHS Lothian said the 37 cancellations were made up of 29 non-urgent elective orthopaedic procedures, for conditions of the bones or ligaments, and eight non-urgent cardio thoracic procedures – surgical treatment of organs inside the the chest such as on the lungs or heart.
The majority of people waiting for non-urgent care will not actually go on to have an operation but may see a specialist about their condition, get a diagnosis or be referred to outpatient services for ongoing care.
NHS Lothian apologised for the ‘upset and frustration’ caused to patients and said that alternative arrangements would be made.
Jacquie Campbell, chief officer of acute services at NHS Lothian, said: ‘In response to the ongoing Covid-19 pandemic and the need to safely manage capacity and balance risk within our sites, 37 non-urgent elective procedures at the Royal Infirmary, Edinburgh were recently postponed.
‘This was required to ensure that we can continue to provide care and treatment to the sickest of patients who need to be in hospital at this time.
‘We understand how upsetting and frustrating this can be for patients, and we apologise to those who have been impacted as a result.
‘We would like to offer our assurance that alternative appointments will be provided as soon as possible.
It comes as Professor Neil Mortensen, president of the Royal College of Surgeons of England, admitted the situation is likely to get worse with more patients being put at the back of a queue.
He told BBC Radio 4’s Today programme: ‘Those most in need obviously come first. And if you’re not an emergency patient then an elective operation – like a hip or a knee – I’m afraid takes second place.’
Professor Mortensen said it is currently ‘really, really tough’, adding: ‘I think it’s going to happen more.’
He did stress that if someone is ‘really in trouble’ with a bleeding ulcer or a bowel obstruction, for example, they will be looked after.
Professor Mortensen said it is ‘tough’ calling patients to tell them their operation is not going ahead because of hospital restrictions.
He said: ‘I guess the theme really is that international comparisons have shown our numbers of ITU beds, our numbers of doctors per head of population, nurses per head of population, have been at the lower end of the scale already.
‘And you add this massive, massive crisis on top of it and it’s very, very easy for it to fall over.’
The Royal College of Surgeons warned earlier this month that there would be a ‘tsunami’ of cancelled operations this winter, with the NHS struggling to cope with a second wave of coronavirus.
The cancellations will add to the growing backlog — with more than 4.2million people on the waiting list and 110,000 of those having waited for over a year.
Even before the pandemic hit, the NHS was struggling to hit its target of making sure at least 92 per cent of patients start treatment within 18 weeks. It had failed to achieve the target for four years.
NHS chiefs have yet to announce any blanket guidelines about restricting care for non-Covid patients, like they did in the spring.
But a number of trusts and health boards have had to take action amid rising hospital admissions in their local area or due to Covid-19 outbreaks on wards.
Across the UK, data shows 1,142 people were admitted to hospital with the coronavirus on October 20, the most recent day information is available for.
For comparison, the figure stood at 693 a fortnight before, and 281 a month ago.
Although hospital admissions have been rising, Covid-19 cases are occupying only seven per cent of all of NHS England’s beds — thought to be around 110,000 in total.
At the peak of the pandemic, this figure was around a quarter, although capacity was freed up when health bosses told hospitals to scrap as many operations as possible and turf out patients on their wards to make way for an influx of Covid-19 patients.
Several hospitals are expecting a surge in Covid patients, with at least seven NHS trusts — in Liverpool, Doncaster, Blackpool, Devon, Warrington, Barnsley and East Lancashire — treating more coronavirus patients on October 20 than they were at the peak of the first wave.
It has led to the cancellation of more operations, some of which may have already been delayed for seven months.
The latest include Bradford Teaching Hospitals, which announced last week it would be suspending some non-urgent surgery from today, and Mid Yorkshire Hospitals Trust, which said on Monday it had closed three operating theatres at Pinderfields Hospital in Wakefield.
Both trusts are in West Yorkshire, which is on the brink of Tier Three restrictions as councillors thrash out plans with senior ministers today.
University Hospitals Plymouth NHS Trust was one of the first to temporarily pause non-critical planned surgery at Derriford Hospital in the second week of October.
The same week, Liverpool University Hospitals NHS Foundation Trust chief executive Steve Warburton told staff in a memo that it had reached a ‘critical point’ and would be scaling back planned procedures. No details of this have since emerged.
Hull University Teaching Hospitals NHS Trust also wrote to patients in the second week of October informing them it could be two years before they are seen, leaving angry patients fearing they may be dead by the time they get an appointment.
In response to the letter, Tim Gardner, a senior policy fellow at the Health Foundation, told MailOnline delays in hospital care will largely be due to coronavirus infection control, like social distancing, restricting how many people can be in the hospital.
He added that the suspension of health care in the UK and over Europe will continue as ‘long as the virus remains a threat’.
He said: ‘Because of the need to make sure that treatment is Covid secure for patients and staff alike, hospital capacity is going to be severely strained for as long as the virus remains a threat. That backlog unfortunately is just going to grow.
‘The real worry right at this moment is that we’ve got winter coming as well. Winter is always a really tough time for the health service.’
NHS England has said the service is still encouraging people to visit hospital for all medical needs if and when they need to, amid fears Britons are still too scared to visit in case they catch the virus.