London NHS hospital in ‘disaster medicine mode’ and ‘can’t provide high standard care’

The UK’s busiest hospital is in “disaster medicine mode” and unable to provide “high standard critical care” because it is swamped by Covid-19 patients.

Dr Julia Grace Patterson, founder of NHS campaign group Every Doctor UK, revealed on Twitter that the Royal London Hospital in Whitechapel had sent an email to notify staff of the dire situation.

The leaked email warned that the Royal London has only one nurse for every three Covid patients being treated in intensive care.

It comes a day after senior medics at the east London hospital urged bosses to declare a major incident because staff were at a “breaking point” as the number of coronavirus patients tripled in just five days – from 200 on Christmas Eve to 638 on Tuesday.

As hospitals across the UK come under increasing strain during the devastating second wave of Covid-19, Dr Patterson tweeted: “From the Royal London Hospital, this email from management: ‘We are now in disaster medicine mode.

“‘We are no longer providing high standard critical care, because we cannot’. The content of this email is SHOCKING.”

Do you work at the Royal London Hospital or are you or a loved one a patient there? Email [email protected]

Ambulances queued outside the Royal London Hospital in Whitechapel
Ambulances queued outside the Royal London Hospital on Tuesday

The leaked email read: “We are now in disaster medicine mode. We are no longer providing high standard critical care, because we cannot.

“While this is far from ideal, it’s the way things are, and the way they have to be for now. Things are going to get harder before they get better.”

The email also revealed: “Every hospital in North East London is struggling, some with insufficient oxygen supplies, all with insufficient nursing numbers.

“Believe it or not, Royal London critical care is coping well relative to some sites.

“We have often had to help out our neighbours by taking patients they simply do not have capacity to manage.”

The note to staff warned: “Kent is in a similar, if not worse, position.”

The number of Covid-19 patients at the Royal London tripled in just five days

Dr Patterson also claimed: “I’ve just seen evidence from Newham Hospital. They need 23 nurses to staff A and E safely tonight

“They are missing 10 nurses due to sickness. This is happening all over. It is an emergency.

“The government must return to Westminster to implement policy to save lives.”

Dr Patterson shared the email with the Mirror and said NHS hospitals across England are in “a total state of emergency” with many understaffed while overrun with Covid-19 patients.

NHS staff are getting sick and they aren’t being replaced fast enough, she said.

She added: ”It’s not just confined to London anymore. We were hearing about huge problems in London and the South East, but the problems now are stretching as far as Wales, up to Scotland, and we are hearing from places in the Midlands now.”

Coid-19 hospital admissions have soared in London due to a new, more infectious strain

At some A&E departments, she said, ambulances are waiting with patients inside for long periods because there are no empty beds.

Patients are waiting up to 30 hours in A&E before being transferred to wards, she added.

Dr Patterson backed calls for a third national lockdown and for NHS staff to be given priority access to the vaccine.

She said: “We feel it’s really appalling that the government isn’t returning to Westminster immediately to deal with the NHS crisis.

“This could be a total disaster unless the government acts immediately and locks the country down and provides a ring-fenced budget for NHS staff.”

“Things are spiralling in terms of case numbers, hospitalisations and the number of deaths.

“Staff are absolutely exhausted. A lot of them have been recalled from annual leave.

“It’s getting worse and the most terrifying thing is we haven’t hit the peak.

“We are not yet seeing the effects of the Christmas mixing period in terms of the spread of this virus, so things are going to get significantly worse.”

Professor Alistair Chesser, group chief medical officer for Barts Health NHS Trust, which runs Royal London and Newham University hositals, said: “The rapid expansion of intensive care beds in our hospitals has led to necessary changes in the clinical staffing model, in line with national guidance.

“Despite this, our dedicated staff are providing high quality care for all who need it thanks to their dedication and skill.”

NHS hospitals in England are treating a record number of Covid-19 patients, and admissions in London have soared in recent days due to a new, more infectious variant of the disease.

Just under half of all major hospital trusts in England currently have more Covid-19 patients than at the peak of the first wave of the virus, latest figures show.

NHS hospitals in England are treating a record number of coronavirus patients

Nightingale hospitals across England are being “readied” for use if needed as Covid patient numbers rise.

This week, ambulances have been seen queueing outside hospitals including the Royal London and Queen’s in Romford, both in east London, and Queen Elizabeth Hospital, Birmingham.

Earlier on Thursday, NHS England reported an additional 529 coronavirus deaths, including 106 in London.

A clinician from the Royal London’s A&E department claimed patients have been forced to wait more than 24 hours for a bed as A&E doctors and nurses were at a “breaking point”.

The number of Covid-19 patients at the hospital had increased by 200 in a matter of days, hitting a crisis point on Sunday nightwhen it was forced to open a new ward and treat adults in a paediatric ward, the Independent reported.

Some sick patients waited hours for an ambulance and gave up, taking a taxi to the hospital instead to beat the queue.

It is said the Royal London issued multiple major incident appeals to staff to come in to work on Sunday and Monday, and urged consultant to review patients for discharge while dozens waited for beds to become free.

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The clinician told the Independent on Wednesday: “We tried to get management to declare a major incident. Ambulances were waiting three hours to offload patients, and adult patients were being treated in the paediatric department because there was no room.

“We ran out of space [by] early evening and patients had been waiting in the department for over 24 hours. We had patients who waited hours for an ambulance but got a taxi in the end and they were so unwell.”

“This is a classic rising-tide major incident. The threat [of a major incident] on Sunday night did alleviate things and we converted two more wards to Covid, but I have never in all my years seen anything like this. It’s worse than March or April.”

Local authorities in Essex have declared a “major incident” as the number of coronavirus cases threatens to overwhelm health services in the county.

Just under half of all major hospital trusts in England currently have more Covid-19 patients than at the peak of the first wave of the virus, latest figures show.

Some 64 out of 140 acute NHS trusts were recording a higher number of coronavirus patients at 8am on December 30 than at any point between mid-March and the end of May.

Workers wear PPE outside the Royal London Hospital during the peak of the first wave in April

This includes 11 of the 14 acute trusts in eastern England and 12 of the 19 acute trusts in South East England.

The figures, which have been published on the Government’s coronavirus dashboard, also show that 42 of the 140 acute trusts had more Covid-19 patients on December 30 than at any point since the pandemic began.

Nightingale hospitals across England are being “readied” for use if needed as Covid patient numbers rise.

The NHS in London has been asked to make sure the Excel centre site is “reactivated and ready to admit patients” as hospitals in the capital struggle.

Other Nightingale hospital sites across England include Manchester, Bristol, Sunderland, Harrogate, Exeter and Birmingham.

On the Nightingales, a spokesman for the NHS said: “Hospitals in London are coming under significant pressure from high Covid-19 infection rates and while staff are going the extra mile and the NHS in London is opening more beds in NHS hospitals across the capital to care for the most unwell patients, it is crucial that people do everything they can to reduce transmission of the virus.

“In anticipation of pressures rising from the spread of the new variant infection, NHS London were asked to ensure the London Nightingale was reactivated and ready to admit patients as needed, and that process is under way.”

The daily number of new confirmed cases of Covid-19 in the UK

The Exeter site received its first Covid patients in November when it began accepting those transferred from the Royal Devon and Exeter NHS Foundation Trust, which was described as “very busy”.

The Nightingale hospitals in Manchester, Bristol and Harrogate are in use currently for non-Covid patients, the spokesman said.

He added: “Covid inpatient numbers are rising sharply so the remaining Nightingales are being readied to admit patients once again should they be needed, in line with best clinical practice developed over the first and second waves of coronavirus.”

NHS England medical director Stephen Powis has described the Nightingale hospitals as “our insurance policy, there as our last resort”.

He told the Downing Street press conference on Wednesday: “We asked all the Nightingale hospitals a few weeks ago to be ready to take patients if that was required.

“Indeed, some of them are already doing that, in Manchester taking step-down patients, in Exeter managing Covid patients, and in other places managing diagnostics, for instance.

The centre has been filled with rows and rows of beds
The London Nightingale Hospital as it was set up in March

“Our first steps though, in managing the extra demands on the NHS, are to expand capacity within existing hospitals – that’s the best way to use our staff.”

Concerns have been raised around the already-stretched health service’s ability to staff Nightingale facilities.

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said: “It is not ‘just the case’ of using the Nightingale hospital as there are simply no staff for them to run as they were originally intended (mini intensive care units).”

NHS hospitals in England are treating a record number of Covid-19 patients – more than 22,000 – and rates of infection are continuing to rise in all regions, according to the latest weekly surveillance report from Public Health England.

The number of people testing positive for the virus in England also reached a new record high, with a total of 232,169 in the week to December 23 – the highest weekly total since Test and Trace was launched in May.

Medics working on the frontline of the UK’s battle against the disease have begged Britons not to mix with others on New Year’s Eve as hospitals come under increasing strain every day.

Intensive care doctor Professor Hugh Montgomery warned people who do not wear masks and continue to mix unnecessarily have “blood on their hands”.

He said anyone who thinks it is acceptable to have “one more night out” is spreading the virus.

He told BBC Radio Five Live: “Anyone who’s listening to this who doesn’t wear their mask and behaves like this – they have blood on their hands, they are spreading this virus. Other people will spread it and people will die.

“They won’t know they’ve killed people but they have.”

Prof Montgomery said the consequences of “bad behaviour” over Christmas will not be seen in intensive care units until next week, and the results of any similar actions by people on New Year’s Eve will be felt in hospitals about 10 days later.

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