Southmead Hospital is taking critically ill Covid patients from as far away as Birmingham because of “extreme” pressures on Intensive Care Units (ICUs) in other parts of the country.
The ICU at the hospital in north Bristol is taking about five Covid-positive patients from other regions each week, and that number is expected to rise, according to a hospital chief.
North Bristol NHS Trust’s Chief Operating Officer, Karen Brown, said it had been a “challenge” to provide safe staffing levels within the ICU and wider hospital. It comes as Southmead hit a peak of nearly 200 Covid-patients in hospital and had to cancel elective surgeries and routine outpatient appointments to cope last month.
Meanwhile, Covid-patients in hospital reached a peak of 258 last month at the University Hospitals Bristol and Weston NHS Foundation Trust.
‘Surge’ plans and managing capacity
ICU capacity is planned on a regional and national level, Ms Brown told members of South Gloucestershire Council’s health scrutiny committee on January 27. Hospitals in the south are expected to submit ‘surge’ plans to NHS England and NHS Improvement to support London, Kent and the Midlands.
Southmead Hospital has expanded its ICU bed numbers from 46 to 55 and accepted ICU patients from “as far as Swindon, out to Yeovil and beyond”, Ms Brown said. “We’ve had patients transferred to us from Kent and also Birmingham as well.”
Seven ICU patients arrived in 10 days and that number is expected to rise to one a day, according to Ms Brown’s presentation. The hospital has also taken dozens of non-ICU patients, with and without Covid, from the Bristol Royal Infirmary and Weston General Hospital.
But people who live in the local NHS area should not worry that there won’t be an ICU bed for them if they get sick, Ms Brown said. “We recognise our absolute requirements to our local population,” she added.
“It’s a clinical decision on a daily basis about who we receive into the organisation from those regional places.
“It’s part of our surge planning process… and we play our part in that to provide a local service for our local residents without question.”
Cancelled operations and lower staffing levels
Having said that, Ms Brown acknowledged that Southmead Hospital has had to cancel most elective operations, other than those for cancer patients and “urgent life and limb”, to free up hospital beds for Covid-19 patients.
The hospital is still carrying out acute operations and neurosurgical work, and providing emergency and trauma services, she said. Routine outpatient appointments were cancelled to the end of January to free up staff for where they were most needed.
“We believe that we have been at our peak between the 19th of January and beyond, where we’ve now got over 200 patients who have been Covid-positive,” Ms Brown said.
Most of those patients are over 60. Those who are younger are usually in hospital for another reason but test positive for Covid-19 on admission, the meeting heard. Ms Brown said it had been “a challenge” to provide safe staffing levels on the wards and within the ICU, where some Covid-positive patients stay for more than two weeks.
“We don’t have staffing to provide critical care nurses to every single patient so the way that we have managed that is a review and a restratification of those patients,” she said.
“So we’ve used experienced people who have had experience within our Intensive Care Units in the intervening period just to manage through Covid and that has been anaesthetic members of staff, it has been physiotherapists.”
The hospital plans its capacity weekly and “fine tunes” it on a daily basis, she said.
Admissions for flu and gastrointestinal illnesses are down on previous years, partly due to social distancing which reduces transmission of all infectious diseases, not just Covid, the meeting heard.