Exclusive: Frantic action to stop London ‘running out of beds in four days’

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London’s critical care units are four days from full capacity without urgent action
HSJ has learned details of massive ramp-up in intensive care beds being phased in over two weeks
Seeking to quadruple ICU capacity in hospitals
Excel conference centre in East London could be used as “giant critical care barn”

Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity.

In a call with local leaders this morning, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak.

According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said.

The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. HSJ understands a detailed breakdown of draft expansion numbers was circulated to trusts by NHS England and NHS Improvement’s regional team yesterday.

According to well-placed senior sources, the draft bed numbers suggested huge increases of more than 10-fold at Royal London Hospital in Whitechapel, Kingston Hospital in south west London, and Croydon University Hospital. The number of surge beds at Northwick Park in Harrow, which declared a “critical incident” last week, would almost double under the draft figures.

However, the trusts running those sites today told HSJ they were querying the draft numbers, as they appeared over-optimistic. At midday today, NHSE/I was asked if final figures were available, and for further clarification.

Meanwhile, health and social care secretary Matt Hancock has this afternoon confirmed plans to open a huge “field hospital” at the Excel conference centre in the Docklands next week, capable of housing 4,000 “people”. It is not yet clear how many intensive care beds this would include.

London has had 155 reported covid-19 deaths as of Tuesday afternoon — up from 109 on Monday. London North West University Healthcare Trust, which runs Northwick Park, reported an additional 21 on Tuesday alone.

Earlier this month, national leaders said the NHS needed a “seven-fold” increase in intensive care capacity, though they later insisted they said “several fold”.

While many covid-19 patients have minor illness, large proportions of those who are admitted to hospital require intensive care — and modelling suggests the NHS’ normal ICU capacity could fall far short.

As reported by HSJ last night, nursing and medical unions have agreed major changes to the normal staff-to-patient ratios for intensive care, which effectively allows trusts to spread their specialists more thinly, and to staff more beds.

However, there is significant uncertainty over the supply and availability of ventilation machines, which are essential in ICU wards.

Several senior leaders have told HSJ London is thought to be around a week ahead of the rest of the UK, in terms of the covid-19 pressures being experienced.

NHSE/I has been approached for comment.