Anaesthetists prepare to join ICUs ahead of coronavirus peak

New guidance by four professional bodies will recommend that anaesthetists update their knowledge of critical care so they can work in ICUs — which are expected to be short-staffed as they deal with demand from the coronavirus pandemic.

Anaesthetists will be asked to work alongside current ICU doctors, rather than in isolation, according to the new guidance from the Faculty of Intensive Care Medicine, Intensive Care Society, Association of Anaesthetists and Royal College of Anaesthetists.

The Royal College of Anaesthetists stressed that intensive care is a core part of the training for all anaesthetists, and there is “much crossover” between the skills of the two specialities.

HSJ has been told around 90 per cent of anaesthetists would need to refresh their skills to work in critical care, but the “cross-skilling” would target those who have most recently qualified or who work the most with critical care patients as part of their day jobs.

It would take between a couple of hours or a few days of “skills refreshers” for anaesthetists more familiar with critical care to be able to work in ICUs, but for others additional re-training could last for a couple of weeks if necessary, HSJ understands. 

Professor William Harrop-Griffiths, council member of the Royal College of Anaesthetists, told HSJ: “We are expecting a surge in the number of patients needing critical care, and it is possible that this will exceed the capacity of critical care units in some parts of the UK.

“Part of this guidance recommends that anaesthetists update their knowledge and experience of critical care management so that they can work with intensive care doctors to manage the surge in demand.

“Intensive care medicine is a core part of the training of all anaesthetists, and there is much crossover between the skills and knowledge of intensivists and anaesthetists. We have recommended that hospitals begin this ‘cross-skilling’ process as soon as possible.”

Ganesh Suntharalingam, president of the Intensive Care Society, said: “Cross-skilling is going to be an essential part of the fight against covid-19, and trusts should already be taking the issue seriously and looking at reducing elective surgery to release staff time to train and prepare.

“Our members tell us that this varies significantly between trusts.”

On 12 March, at the time of writing, the number of coronavirus cases in the UK reached 590 — which was the highest rise in 24 hours for the second day running.

Keith Willett, NHS England strategic incident director, has said hospitals should be planning to more than double their intensive care capacity. Sources at a conference this week told HSJ Professor Willett said a “seven-fold” increase was needed, although he subsequently denied this – stating that he said “several-fold”.

An NHS England spokesman said: “As the chief medical officer has said, services will come under pressure as coronavirus spreads more widely over the coming weeks, so its entirely right that the NHS and dedicated health professionals prepare flexibly to respond.”