NHS under ‘enormous strain’ in England as trusts declare critical incidents

Hospitals and ambulance services across England are under “enormous strain” fuelled by “heavy demand”, “severe” staff shortages and soaring Covid cases, health leaders have warned after NHS trusts covering millions of patients declared critical incidents.

Dr Layla McCay, director of policy at the NHS Confederation, which represents the whole healthcare system, said the situation had become so serious that “all parts” of the health service were now becoming “weighed down”. This will have a “direct knock-on effect” on the ability of staff to tackle the care backlog, she added, as well as the current provision of urgent and emergency care.

She sounded the alarm after a major ambulance trust, South Central Ambulance Service (SCAS), which covers 7 million people across Berkshire, Buckinghamshire, Hampshire, Oxfordshire, Sussex and Surrey, declared a critical incident after “extreme pressures” forced it to prioritise patients with life-threatening illnesses.

At the same time, six hospitals across Yorkshire issued a joint warning for people to stay away from emergency departments except for in “genuine, life-threatening situations” after a surge in numbers left some patients waiting for up to 12 hours.

“With nearly 20,000 people in hospital with coronavirus in England, these latest critical incidents highlight how once again the pressure on our health service is mounting,” McCay said. “Ambulances, A&E departments and frontline providers of care across all parts of the NHS are weighed down by heavy demand.

“Healthcare leaders and their exhausted teams are doing their utmost to provide patients with the treatment they require, but with 110,000 vacancies across the NHS, they also need urgent support from government to address severe workforce shortages. With one in 13 people now Covid-positive and cases still rising in older people, as we learn to ‘live with Covid’ there will be a direct knock-on effect on the NHS’s ability to tackle waiting lists.”

Saffron Cordery, deputy chief executive of NHS Providers, said NHS trusts “right across England” were under “enormous strain” caused by rising numbers of people with Covid-19 in hospital, a very high number of beds being occupied, staff absences and severe workforce shortages. “Trust leaders and everybody in the NHS are keenly aware of the impact of delays and addressing them is an absolute priority,” she added.

SCAS declared a critical incident on Wednesday after a huge volume of callouts the previous day and asked people to only call 999 in a life-threatening or serious emergency.

Mark Ainsworth, director of operations at SCAS, said: “We declared a critical incident in the early hours of the morning due to extreme pressures across our services.

“This was related to the level of demand with a large volume of calls being received throughout the day and into the night, and increased challenges in releasing some of our ambulances from busy acute hospitals. This then impacts our ability to get crews back on the road to respond to patients.”

Meanwhile, hospital trusts across West Yorkshire and Harrogate (in North Yorkshire) – an area covering more than 2.5 million people – said the current pressures have left them with no choice but to prioritise patients presenting with acute illness or injuries.

West Yorkshire Association of Acute Trusts (WYAAT) said its most recent emergency department figures show a 14.2% increase in attendances, compared with the same week last year.

Dr Andrew Lockey, emergency medicine consultant with Calderdale and Huddersfield NHS Foundation Trust, said: “Our hospitals are extremely busy, and people are having to wait a long time to be seen.

“Over the past two weeks we’ve faced huge challenges with the sharp uplift in the number of people attending accident and emergency. This places additional pressure on our teams who are responsible for treating patients with serious and life-threatening conditions.”

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