NHS crisis continues as bosses warn of 'massive problems'

NHS staffing crisis sees ambulances taken off the road and sparks fears care may be RATIONED – as hospitals go on ‘war footing’ and begin erecting ‘Nightingale’ wards in car parks… but health chiefs warn they can’t ‘magic up’ staff to oversee them

  • A paramedic said today their service was ‘completely broken’ and no longer able to respond to emergencies
  • Chris Hopson also admitted that staff absences meant many ambulances were coming off the road
  • NHS England is building ‘mini-Nightingale’ hospitals, but concerns have also being raised about staffing 

The Omicron-fuelled staffing crisis in the NHS was laid bare today as paramedics warned ambulances were being taken off the road because of a lack of emergency responders. 

One paramedic in Sheffield claimed teams were taking 24 hours to reach patients suffering from ‘urgent’ pains or burns. The NHS aims to attend category three calls — the name for these types of calls — within two hours. 

They branded the service ‘completely broken’ and said it was no longer for emergencies, adding that ‘very few’ of the calls were from people who didn’t need medical help.

Chris Hopson, chief executive of NHS Providers — which represents ambulance trusts, admitted today that a high level of staff absences meant ‘significant numbers’ of ambulances were out of use.

And GPs warned of ‘massive problems’ while NHS bosses in Scotland — where the Army has already being drafted in to help struggling wards — say a wave of cases could force them to ration care to just the sickest patients. 

It comes as the NHS today shifted to a ‘war footing’ and began constructing eight mini-‘Nightingale’ wards in staff car parks, in preparation for an expected surge in patients.

The make-shift units will be able to treat up to 100 Covid patients each. But questions have been raised over how the hospitals will be staffed, given the NHS was already short of 100,000-plus workers before the pandemic hit.

Addressing the topic, Mr Hopson said: ‘You can’t just magic up the number of staff that are needed to staff these beds out of thin air.’ And Pat Cullen, from the Royal College of Nursing, said she had ‘no idea’ how the hubs would be manned.

Omicron has left the NHS facing a major staffing crisis with thousands off isolating due to the virus, as cases reach record levels throughout the country.

WILLIAM HARVEY HOSPITAL IN ASHFORD, KENT: Pictured above is construction work beginning on the William Harvey ‘mini-Nightingale’ hospital, situated in the site’s car park

Pictured above is an ambulance outside the Royal London hospital. Fewer ambulances are on the road because of staffing shortages, and many are also still stuck queuing outside A&E departments trying to offload patients

The above shows where England’s eight new ‘mini-Nightingales’ will be set up. These will aim to treat 100 Covid patients following a stay in intensive care, and will be on hospital sites to ensure they can be properly manned. Previous Nightingales could not get enough nurses

ST GEORGE’S HOSPITAL, SOUTH LONDON: Construction workers began erecting a temporary field hospital in the grounds of St George’s Hospital in Tooting today

Ambulance response times to category 2 calls – patients suffering strokes or heart attacks – surged in October but dropped again in November. They remain far above the 18 minute target however

It comes as NHS Covid hospitalisations also began to creep upwards amid the rapid spread of the Omicron Covid variant

Ministers have slashed self-isolation from ten days to seven for those that test negative on two lateral flow swabs taken 24 hours apart. But they are now being urged to cut this to five days, in line with the US, to ensure staff can get back to the frontline faster. 

Mr Hopson said: ‘If absence rates and care quality/patient safety risk rise, pressure for a change to the isolation period will, inevitably, rise as well.’

Jack Grehan, a paramedic working in Sheffield, wrote on Twitter: ‘[Ambulance] land is completely broken.

Covid hospitalisations in England have almost doubled in a week to levels not seen since the country’s devastating second wave. 

Some 2,082 virus-infected patients were placed on wards on December 28, a leap of nearly 90 per cent compared to the figure the week before. It marked the highest daily total since February, according to Government data. 

But experts have called for caution over interpretations of the hospital numbers amid the rapid spread of Omicron, given that patients are suffering milder disease now than in previous waves.

Official data also shows the number of critically ill Covid patients remains stable, highlighting how the outbreak is now in a vastly different position to ever before.

NHS England data also showed hospitalisations in London — the epicentre of the UK’s Omicron crisis — increased yet again, with 456 newly-infected patients placed on wards on December 28. The figure was up by around 50 per cent on the previous week.

It means the capital’s daily admissions have for two days in a row been above the crucial 400-a-day threshold that Government advisers warned could trigger nationwide intervention. 

But statistics looking at the situation in intensive care wards paints a much different picture, with just 232 patients hooked up to ventilators as of today. Rates are ticking up much slower, and are still a fifth of levels seen in January during the depths of the Alpha wave. 

‘We are no longer an emergency service. We are doing Category 2 calls [people suffering a stroke or chest pain] in three-quarters of an hour old at times, and Category 3’s almost 24 hours later. 

‘I would add as well that most of the jobs I’ve been doing are actually unwell people or need some kind of urgent care that they haven’t been able to access via other means.

‘Very few ‘why am I even here’ type jobs lately.’ 

Mr Hopson warned staff absences due to Covid were ‘clearly now having a significant impact’ across the NHS as well as in other businesses including hospitality.

He added: ‘NHS experience suggests that the impact varies considerably depending on how many staff are isolating, driven by local community infection rates; ability to rapidly source temporary replacement staff; and ability to flex existing staff to cover work of those who are absent.

‘For example, some NHS ambulance trust CEOs are saying their current staff absence rates mean significant numbers of ambulances (are) off the road, given the need to have appropriately trained staff in each ambulance.’ 

Ambulances are also still having to wait up to seven hours outside hospitals in some parts of the country before off-loading patients. 

Shane Clark, of Unison’, told the BBC ambulances in the South West were left without ‘any light at the end of the tunnel’ for the next two months. 

‘When you’re waiting with a patient in the back of an ambulance for four, five, six, seven hours, it is really, really sad,’ he said.

‘I didn’t join the ambulance service for this, my members didn’t join the ambulance service for this, we are there to provide a gold standard of care.’

Meanwhile, the chairman of the Royal College of GPs, Professor Martin Marshall, said Omicron is still ‘spreading like wildfire’ and causing ‘massive problems’ for doctors’ surgeries.

He told Times Radio that growing numbers of staff being forced to self-isolate combined with the challenges of ramping up the vaccination programme has put practices under strain.

Professor Marshall, who works as a GP in east London, said: ‘Covid is still spreading like wildfire and that’s having massive implications on the health service generally.’

He added: ‘What we’re seeing is more and more patients that we’re seeing in general practice, we’re advising in general practice, with Covid symptoms.

‘We’re seeing increased numbers of staff who are having to self-isolate and either working from home if they’ve got the electronic capability to do so, or just not being able to contribute and that’s putting pressure on the rest of the staff left in general practice.’

Latest figures showed Covid absences have surged almost 50 per cent in the NHS over the three weeks since the start of December, from 12,500 to 18,800. Total absences have also ticked up from 60,000 to 64,000.   

There are also mounting warnings over the situation in the NHS in Scotland, with absences and spiralling cases threatening to leave hospitals able to provide ‘urgent healthcare only’.

Dr Lewis Morrison, the chair of the British Medical Association in Scotland, said that without ‘big changes’ in either infection levels or the rules on self-isolation, the health service could find itself in such a situation. 

Nightingale wards are erected in hospital car parks as NHS goes on ‘war footing’ 

The NHS cannot ‘magic up’ staff to oversee temporary ‘Nightingale’ wards in hospital car parks, health leaders warned today as construction workers began erecting eight make-shift sites.

NHS chiefs last night announced eight hospitals in England will start building temporary structures this week to house up to 100 Covid patients each. Work has already started at St George’s Hospital in South London and the William Harvey Hospital in Ashford, Kent.

The overspill sites — which could also be erected in canteens and gyms if needed in the coming weeks — will be equipped with beds and machines for patients who still need minor treatment.

The drive forms part of a new NHS ‘war footing’ to tackle the Omicron wave, which is starting to pile pressure on hospitals.

But questions have already been raised as to how the units will be manned amid the spiralling rates of absences among the health service coupled with the 100,000-plus vacancies before Covid struck.

Chris Hopson, chief executive of NHS Providers — which represents hospital trusts — said staffing the makeshift wards posed a ‘major challenge’ and that ‘you can’t just magic up the number of staff that are needed to staff these beds out of thin air’.

He added, however, that having the facilities on existing hospital grounds ‘maximises the NHS’s ability to meet that challenge’ and that he expects volunteers will be called in if the sites were needed to be used.

Health Secretary Humza Yousaf refused to rule out the need for field hospitals — as the NHS in England started setting up new Nightingale ‘surge hubs’ at hospitals. 

Dr Morrison spoke out about the impact that having large numbers of staff self-isolating was having on services, saying: ‘If you go to work and you’re missing colleagues, then there is extra work to do.’

But he told BBC Radio Scotland’s programme: ‘Additional to that, there is going to work and not knowing how many colleagues you are going to have. I worked the Christmas weekend and two colleagues essentially were self-isolating, one going into the weekend we knew already and one was essentially sent home because someone they lived with tested positive.

‘It’s that level of anxiety I think people feel, not knowing how much work you are going to have to do and how long you are going to have to stay when you go into work.

‘That is on the back of the fact that we have been dealing with this pandemic for a very long time, people are pretty washed out.’

Speaking about the ongoing impact of the pandemic on the NHS, he added: ‘When the system comes under pressure you have to have a plan to be able to shut down the less urgent things and redeploy people to the absolutely essential things, urgent care, the front door of hospitals.

‘The problem with that is trying to do it at short notice and of course the expectation people understandably have that having aspects of their healthcare postponed yet again, nobody wants to do that.’

He added: ‘I think over the coming weeks we may have to find ourselves in a situation where we support urgent healthcare services only, unless there is a big change in either the numbers or the rules.’ 

All of England’s eight ‘mini-Nightingales’ will be scattered around the country, with sites based in London, Bristol, Leeds, Kent and Leicester among others.

In contrast to the first wave — when facilities such as London’s ExCel centre were converted into giant hospitals — the ‘Nightingale hubs’ will be situated on existing hospital grounds.

Health chiefs said this will make it easy to deploy staff if there is a surge in admissions over the coming weeks that outstrips current capacity.

NHS Trusts have also been asked to identify areas such as gyms and classrooms that can be converted to temporary Covid wards.

They said this could create an additional 4,000 ‘super surge’ beds across the country — eight times the capacity of a large district hospital, which has around 500 beds.

Mr Hopson said: ‘Building on lessons learnt from earlier in the pandemic, trusts are identifying extra capacity on existing hospital sites that could be turned into super surge capacity should it be required.

ST GEORGE’S HOSPITAL, SOUTH LONDON: One member of a construction team was pictured working on the roofing of the make-shift site 

WILLIAM HARVEY HOSPITAL IN ASHFORD, KENT A view of the make-shift Nightingale site set-up in a car park on the grounds of the William Harvey

‘Trust leaders hope this back up insurance policy will never be needed, as with the original Nightingales. But it must be the right ‘no regrets later’ move to make these preparations now.

‘Given the other pressures on the NHS and the current level of staff absences, staffing this capacity would be a major challenge.

‘But co-location on existing hospital sites maximises the NHS’s ability to meet that challenge.’

He added: ‘We also need to recognise that this will add further stretch to an already hard-pressed NHS.’

In a follow-up interview with The Telegraph , he added: ‘I think there’s a very clear recognition in the NHS that you can’t just magic up the number of staff that are needed to staff these beds out of thin air.’

And he told MailOnline: ‘If the NHS is using these hubs, we will be in an emergency and we would use an emergency staffing model.

‘We would, for example, be redeploying staff from less critical activity, we would be calling for recently retired staff and experienced volunteers to help.’

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