Current situation ‘extremely worrying’ says SAM immediate past president

As pressure continues to rise across the NHS, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said in a statement today (28 December):

“The current situation is extremely worrying as the numbers of Covid patients are increasing rapidly at the time of year when things are always ‘tight’. 

“With the numbers approaching the peaks from April, systems will again be stretched to the limit. It is not ‘just the case’ of using the Nightingale hospitals as there are simply no staff for them to run as they were originally intended (mini intensive care units).

“They could play a role perhaps if used as rehabilitation units for those recovering but, again, where do we find the specialist staff – the NHS simply does not have the capacity to spare anyone.

“Using ‘surge’ capacity as NHS England suggests will mean mobilising any usable bed area and stretching staff to look after patients there – often outside the normal ‘comfort zone’ of staff, e.g. unwell medical patients on surgical wards, or, even less safely, opening up ‘mothballed’ areas (‘ghostwards’ from previous years) and spreading staff more thinly than usually considered optimal or even safe.

“This will, of course, mean cancelling elective care again. With ICU capacity there will be a need to utilise every ICU bed in a region and the nursing operating theatre areas like in the Spring, again hitting elective surgical lists.

“If there was a glimmer from the second wave in the north it was that ICU capacity didn’t get quite so bad but the flip side was that many more patients were treated with ‘respiratory support’ outside ICU, meaning ward staff stretched further with the wider use of what is called CPAP (aka non-invasive ventilation).

“Outside of London, the worry at the moment is that all of the same issues are occurring but from a worse ‘starting point’ as the midlands/north never really exited the second wave. 

“Staff illness is also a major concern now with suggestions 10% are already affected but that is likely to worsen.”