Exclusive: Hospitals face ‘most difficult period’ since start of pandemic, NHSE warns

In a letter to trust chiefs in the Midlands this morning, seen by HSJ, NHS England regional officials said trusts were facing increased pressures from covid-19, particularly in areas with lower levels of vaccination.

It says: “[The pressures are] compounded by the impact on staff absences and the need to maintain separate pathways.

“At the same time, we are seeing unprecedented pressure on urgent and emergency care while trying to maintain the momentum created to tackle the long waiting elective patients…

“We are entering, potentially, what will be the most difficult period since wave one of the pandemic…

“The distribution of admissions and critical patients is uneven and closely linked to the lower levels of covid-19 vaccination.”

Trusts such as Sandwell and West Birmingham Hospitals Trust and University Hospitals Birmingham FT have reported significant pressures from covid admissions in recent weeks. An internal message to staff, reported by local media, said this was partly a result of “a deprived and diverse population who have a very high vaccine hesitancy”.

The NHSE letter, signed by Jeff Worrall, the Midlands director of performance and improvement, Siobhan Heafield, regional chief nurse, and Nigel Sturrock, regional medical director, added: “There are clear indications that we are heading towards a period where we need to surge capacity, which is why we are writing to respectfully recommend the following system actions that will help us all prepare for increased pressure across the region.”

NHSE said it would expect all units to ensure they have 100 per cent of their funded baseline critical care capacity available, and to open additional beds if this is needed to “relieve pressure on other units”. This would generally involve redeploying staff and reducing elective care.

They must also ensure patients that need emergency or time critical surgery can have this within an “appropriate clinically required time”.

The letter finishes: “We don’t doubt the challenge this presents providers and we recognise the importance of the well-being of your staff at this time.

“We also recognise that our requirement will have to draw on your reservists and impact on routine surgery. We expect any decisions about systematic reductions in routine surgery need to be taken at an integrated care system level and in consultation with ourselves.

A spokesman for NHS England and Improvement in the Midlands said: “The NHS has tried and tested plans for managing extra demand, including by flexing critical care as needed. People should continue to come forward for the care they need, including by using NHS 111 or contacting their GP and of course, it remains vital that everyone gets their vaccination to protect themselves and their communities against the virus.”

This story was updated at 13:33 with a statement from NHSE/I.