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Bristol’s NHS trusts scaling up critical care capacity while hospital admissions remain stable

Internal emails said one of Bristol’s hospital trusts had planned to triple capacity, but local NHS bosses have declined to reveal more detail on their preparations.

Coronavirus in Bristol

Bristol’s NHS trusts have refused to reveal the details of their capacity planning, as hospitals across England are freeing up critical care beds to deal with future cases of coronavirus. 

This comes as official data shows that the number of people in hospital with covid-19 in the south west has remained stable over the last week, in the region of 800. The government has said this is proof the lockdown measures are beginning to have a positive impact.

Critical care capacity is a key measure of how well-equipped the NHS is to cope with the peak in coronavirus cases, as doctors and nurses in other countries have been forced to choose whose life to save because of lack of resources. 

As of February 2020, there were a total of 101 adult critical care beds at the BRI and Southmead Hospital, but this has increased, as Bristol’s hospitals have been cancelling routine operations and appointments and experiencing fewer people coming to A&E.

In internal emails to staff at University Hospitals Bristol NHS Trust (UHB) seen by the Cable, the trust said in mid-March it was planning to triple its critical care capacity in order to be able to ventilate three times as many patients as normal.

When the Cable asked for more details on the plans to increase critical care capacity, a spokesperson said the trusts did not want to give out specific data because it would be time consuming, go out of date quickly, and force them into answering more questions about resources.

Instead, the joint statement from the local Clinincal Commissioning Group (CCG) and the two NHS trusts, said “extensive preparations” were underway across the region, including postponing non-urgent appointments and treatments to free up frontline staff, in order to increase critical care capacity to deal with the “expected rise in severely unwell patients”.

The Cable also asked about availability of personal protective equipment (PPE), after seeing numerous requests for donations by NHS workers on social media and hearing from sources that stocks had been stolen from at least one trust in Bristol. The statement said supplies were “currently reasonable across healthcare organisations throughout the area”.

Maureen Ellington. Photo: NBT

This became all the more important after the tragic news yesterday that Maureen Ellington, a healthcare assistant at Southmead Hospital in her early 60s had died after testing positive for coronavirus. North Bristol NHS Trust paid tribute to Maureen, who had worked for the NHS for over 25 years, describing her as “well-loved by every colleague and patient she came into contact with”. There have so far been 96 deaths recorded as from coronavirus in Bristol’s hospitals. 

How hospitals in the region are faring

A graph from the government’s daily press briefing, 14th April

Both the number of people currently in hospital with covid-19 and confirmed positive cases are lowest in the south west compared with other regions in England. 

Local NHS bosses said the new Nightingale Hospital at UWE’s Frenchay campus would open next week, with a capacity for 1,000 patients from across the south west. 

However, in London, the worst affected area in the UK with more than 3,000 deaths, evidence from the Easter weekend shows that the capital’s Nightingale hospital is barely being used at the moment, as hospitals there have managed to double their intensive care capacity, with about 80% of those occupied.

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The apparent stabilisation of people with coronavirus being admitted to hospital in the south west mirrors the national picture. Yesterday, Steve Powis, National Medical Director of NHS England, said: “There’s increasing evidence that the number of hospital admissions is plateauing.” 

Over the weekend, there were nearly 40,000 general acute beds available– roughly 40% of the total – according to figures from the national NHS operational dashboard revealed by the Health Service Journal (HSJ), The dashboard also showed more than 3,200 patients were in critical care beds. 

The number of adult critical care beds in England as of February was 4,122. This figure has gone up since then, but it remains unknown by how much. A confidential NHS report leaked to the Independent revealed that the health service estimates it will need more than 6,100 critical care beds at the peak of the virus in early May, and considerable capacity until late July.

In the debate about critical care capacity, the UK doesn’t compare favourably with countries like Germany, which has been praised for superior testing and better resources in their healthcare system. When the pandemic began, Germany had 28,000 intensive care beds, but this has risen to 40,000.

Dr Martin Jones, medical director for Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, told the Cable: “Should it be required, the NHS Nightingale Hospital Bristol will be ready to accept its first patients week commencing 20 April 2020. This will care for up to 1,000 people. The hospital will coordinate care with critical care units across the West of England.

“We will also be carrying out staff testing, prioritising areas with the greatest clinical need while testing capacity remains limited. As is the case across the country, we will be able to increase testing over the coming weeks.

“Protecting patients and staff is our first priority, and we are following the expert national guidance on personal protective equipment. There are currently reasonable supplies across healthcare organisations throughout the area.”

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