‘Things are grim here’: doctor tells of dire situation in north-west England ICU

'Ek work in an ICU [intensive care unit] in the north-west of Engeland. Things are grim here. The north-west seems not to have had a reprieve from Covid-19. We were the first region to see cases rise again after the winter lockdown and they haven’t really dropped since. Several of our wards are now dedicated Covid wards, which means that non-Covid patients need beds elsewhere.

Things are horrendous at the moment. Staffing is a big problem. One in five of the nurses on our intensive care unit are sick at the moment. We are fighting to get people to work any and every shift. It’s very difficult to get bank or agency staff. Nurse to patient ratios on non-ICU wards overnight are regularly unsafe, so people are pulled from managerial positions to fill gaps.

About a third of our ICU beds just now are occupied by Covid patients, including a few pregnant young women who are extremely unwell. This is having a major impact on our ICU and our ability to provide beds for elective patients – people who are waiting to have planned surgery. That is forcing the trust to cancel operations. There’s just a daily toss-up for beds and lots of pressure on us to carry on despite having too few beds and too few staff.

Operations are being cancelled as a result. Even cancer operations get cancelled, because we don’t have enough ICU beds for the patient to recover in after surgery. Egter, those ones only involve a small delay and we usually manage to get them done the same week. Cancers are being prioritised. It’s the elective operations that don’t involve cancer that are really hampered, wel, people waiting for things such as a new hip or knee. Non-cancer cases are the first to go.

Our operating theatres have been running at only about half their usual capacity for weeks. That means we stop bringing patients into the hospital because we don’t have enough beds for them, because we need the beds for medical and Covid patients. It’s horrendous for the patients affected by cancellations and it leaves staff in extreme distress about not being able to get people treated.

There is no obvious plan for what on earth we’ll do and there’s no end in sight. How will we ever be able to get patients who are waiting for treatment in for their surgery at this rate? There appears to be no gameplan at all. It’s remarkable that there isn’t more coverage of that.

There is immense demand for both Covid and non-Covid A&E care. And we have high numbers of “medically fit for discharge” patients who are blocking acute beds because too few of them go back into the community. That’s another reason we have had to cut admissions for elective surgery.

Everyone in the hospital is trying their best but the flow of patients through the hospital is very strained and there is massive competition for beds. Just in the last few days there seems to have been a slight reduction in people pouring through the door, so I hope that continues.

Having worked in the NHS vir 15 years I have never seen things so stretched. Staff morale is at rock bottom. Lots of nurses are leaving. Lots of people are retiring early and others are moving to work in less acute specialities than ICU. It feels like the NHS has been absolutely decimated.”

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