Sir Simon Stevens
The NHS will move to its highest alert level from midnight tonight in anticipation of a wave of coronavirus hospital admissions in the coming weeks.
Sir Simon Stevens – NHS England’s chief executive – said the move to level four was in response to the ‘serious situation ahead’.
Coronavirus-infected patients are continuing to pour into hospitals across the country, particularly in hotspots in the north, and take up beds that could be used to to treat people with other conditions.
A move to level four means health bosses believe there is a real threat that an influx of Covid-19 patients could start to disrupt other vital services.
Triggering the alert means all trusts have to report to NHS England centrally so it can track capacity levels in every region.
Sir Simon claimed the NHS is currently treating the equivalent of 22 hospitals’ worth of Covid-19 patients.
He said: ‘The facts are clear, we are once again facing a serious situation. This is not a situation that anybody wanted to find themselves in, the worst pandemic in a century, but the fact is that the NHS is here.
‘The public can help us help you so our fantastic staff – our nurses, our doctors, our paramedics – can get on with looking after you and your family there when you need it.’
Leaked documents, seen by The Telegraph, revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun
It comes after a leaked document showed hospital bed occupancy this year dropped to its lowest percentage for a decade when medics had to turf out thousands of inpatients to make room for a predicted surge in people with Covid-19. Now that normal care has resumed, a leaked report suggests there are still fewer than average numbers of beds in use
No10 justified the blanket draconian measures on frightening projections that the NHS could run out of beds within weeks.
Echoing the gloomy warnings of No10’s top scientific advisers, Sir Simon told BBC Radio 4’s Today programme that by the end of November, there will be more Covid patients than there were during the first peak in April.
Sir Simon today admitted, however, that the NHS never ran out of room during the first wave and claimed that the national lockdown will mean the health service continues to have space throughout the winter to keep up normal services and tackle backlog created from cancelling thousands of operations in the first wave.
Thousands of beds went unused after bosses decided to scrap non-urgent operations to make way for predicted onslaught of coronavirus patients. Make-shift Nightingale units were left virtually empty.
Sir Simon’s comments come after leaked documents today revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun.
Eighteen per cent of critical care beds available across the health service nationally, which is normal for the autumn.
Data from the NHS Secondary Uses Services, seen by The Telegraph, claims to show that even in the worst hit region, the North West, seven per cent of critical care beds are still free.
Experts said hospitals are running ‘at normal levels’, in stark contrast to the picture which is being painted by the Government, which has honed in on the small handful of hospitals that are under more pressure than in the spring.
It comes as MPs prepare to vote on a new four-week Covid-19 lockdown for England.
But Boris Johnson is facing a Tory revolt in a crunch Commons vote today – with fears he will have to rely on Labour to get the plan through.
The draconian measures, ordering people to stay at home and shutting non-essential retail, bars and restaurants for a month, are set to come into force from midnight.
But while Sir Keir Starmer’s backing means the PM is assured they will be rubber-stamped by MPs this afternoon, he is scrambling to contain a rising tide of anger on his own benches.
The number of Covid-19 patients in English hospitals has soared almost five-fold from 1,995 on October 1 to 9,213 on the 31st, Department of Health data shows.
‘In a sense the facts speak for themselves,’ Sir Simon told BBC Radio 4’s Today programme this morning.
‘We began early September with under 500 coronavirus patients in hospitals by the beginning of October that had become 2,000 and as of today that is just under 11,000.
‘Put another way we’ve got 22 hospitals worth of coronavirus patients across England and even since Saturday when the Prime Minister gave his press conference we’ve filled another two hospitals full of severely ill coronavirus patients.’
Sir Stevens’ comments add further confusion to whether NHS hospitals are truly overwhelmed, after documents from the NHS Secondary Uses Services (SUS), a body which provides data for purposes such as healthcare planning, shows capacity in ICU was on a normal path in October.
IS THE NHS ACTUALLY QUIETER THAN USUAL?
NHS hospitals in England appear quieter than usual for this time of year even though they are treating more than 9,000 patients with coronavirus.
A leaked document claims 84 per cent of all hospital beds were occupied across the country yesterday, which is lower than the 92 per cent recorded during autumn last year.
Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade.
The only exception to this was between April and June this year, when it stood at 64 per cent because hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic.
Regional differences in the coronavirus outbreak mean some places are feeling more strain than others – one major hospital trust in Liverpool is already be treating more Covid-19 patients than it was in the spring.
Medics fear the numbers of people needing care for Covid-19 will become so large that they won’t be able to treat people with cancer and other serious diseases.
Doctors already face a huge backlog in cancelled or postponed non-urgent operations and procedures, on which they are now desperately trying to catch up. A resurgence in people who need saving from Covid would put this progress in jeopardy.
But the data obtained by the HSJ shows that hospitals are less full than usual despite having 70 per cent more patients than they did in the spring.
They have around twice as many non-Covid patients – more than 70,000 on wards as of yesterday – along with 9,000 coronavirus patients, and still have at least 10,000 beds available.
At the most recent measure – during the first quarter of 2020/21 – the NHS had a total of 118,451 beds available, of which 92,596 were general hospital beds. The others were on maternity, mental health and learning disabilities units.
This is not thought to include capacity in Nightingale hospitals or private wards that have been rented out. Thousands of beds were put on standby when ministers feared a catastrophic wave of patients with coronavirus, but many were never used.
Full data has not been published about daily bed occupancy and the NHS is coming under growing pressure to show the real state of pressure on its hospitals.
Figures seen by The Telegraph show there is still 15 per cent ‘spare capacity’ across the country – fairly normal for this time of year.
That’s even without the thousands of Nightingale hospital beds which will provide extra capacity if needed.
Even in the North-West, the worst affected region in the ‘second wave’, only 92.9 per cent of critical care beds are currently occupied.
And in the peak of the Covid outbreak in April, critical care beds were never more than 80 per cent full, according to the data.
There were around 5,900 critical care – or ICU – beds in the NHS in January 2020, according to the King’s Fund.
It is not clear how many Covid-19 patients are on critical care wards as this data is not available. But the number of patients on a ventilator – 952 on November 3 – gives a rough idea. However, not all patients on ventilators are classed as being in ICU.
The SUS documents show there were 9,138 Covid-19 patients in general hospital beds in England as of 8am on November 2.
Yesterday this figure was 10,377 – the highest it has been since the beginning of May but following a drop of patients in hospital at the weekend.
It means Covid-19 patients are accounting for around 10 per cent of general and acute beds in hospitals, which has gradually been increasing over the month of October.
However, there are still more than 13,000 beds available on general wards, considering there are almost 114,000 NHS beds in England overall.
MailOnline revealed at the height of the first wave in April that Covid-19 patients never made up more than 30 per cent of the total beds occupied. Just under 19,000 patients out of 70,000 in hospitals at that time had Covid-19.
An NHS source told The Telegraph: ‘As you can see, our current position in October is exactly where we have been over the last five years.’
Commenting on the new data, Professor Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford, said: ‘This is completely in line with what is normally available at this time of year.
‘What I don’t understand is that I seem to be looking at a different data-set to what the Government is presenting.
‘Everything is looking at normal levels and free bed capacity is still significant, even in high dependency units and intensive care, even though we have a very small number across the board. We are starting to see a drop in people in hospitals.
‘Tier Three restrictions are working phenomenally well and, rather than locking down, I would be using this moment to increase capacity.’
The leaked documents also show that no intensive care units are in Covid-19 Pandemic Critcon levels above two.
Critcon levels – used to give an idea of how stretched a hospital is – at three and four are enacted during a ‘full stretch’ and ’emergency’, when other wards need to be used for critical care.
COVID-19 CASES WORSE THAN ‘GLOOM MONGERS’ FEARED, ICU DR SAYS
An intensive care consultant has said the number of coronavirus cases looks worse than ‘even gloom-mongers like me had feared’.
Dr Richard Cree works at the James Cook University Hospital in Middlesbrough and writes on his nomoresurgeons.com blog about his role.
In a post on Tuesday, he said that there were 93 Covid-19 patients in the hospital at the weekend, with ‘significant numbers’ requiring continuous positive airway pressure on the three coronavirus wards, and more ventilated patients in intensive care.
Dr Cree said when the government’s leading scientists presented the worst-case scenario in September, growth of cases was low and deaths even lower.
He wrote: ‘As a result, most people refused to believe such a prophecy. It turns out that everyone was wrong and that the situation looks much worse than even gloom-mongers like me had feared.’
He believed the second lockdown would not be as effective as the first because schools will remain open this time.
Dr Cree also said the number of coronavirus patients in the hospital was ‘having a worsening effect on the hospital’s ability to function normally’ and some surgery has had to be suspended.
He added: ‘This disruption is likely to continue for the rest of the week. However, the organisation continues to do its utmost to ensure that most surgery will continue as normal and there is to be no disruption to urgent and emergency operations.’
It comes as hospitals in Manchester have begun reorganising beds to provide more oxygen treatments for Covid patients, but is expected to fill its initial 36-bed allocation in the Nightingale by next week.
Manchester council’s health scrutiny committee heard there are now around 300 patients with coronavirus in the city’s hospitals but that hospitals are committed t treating patients with non-Covid issues for as long as possible, the Manchester Evening News reported.
Katie Calvin-Thomas, interim chief executive of Manchester’s Local Care Organisation – said ‘hospitals are looking at how they reorganise their beds and their staffing to create additional capacity in intensive care for people who require oxygen’.
Mark Edwards, chief operating officer of the LCO, said there are currently nine Manchester patients in the Nightingale.
‘That will grow quite rapidly ahead of the weekend and I suspect the first ward – which is where we will need the 36 beds – is likely to be filled early next week, if not before,’ he said.
But 146 units out of 222 (65 per cent) are still at ‘Critcon 0’, which is defined as ‘business as usual’ by the NHS.
Just 29 units (13 per cent) are at ‘Critcon 1’, defined as the usual impact of a bad winter, according to documents seen by The Telegraph.
Only 19 (eight per cent) are at ‘Critcon 2’, described as a ‘medium surge’. Twenty-eight units have not reported their position.
The figures come after leaked documents, seen by the Health Service Journal, revealed NHS hospitals in England appear quieter than usual for this time of year.
Some 84 per cent of all hospital beds were occupied across the country on Monday, which is lower than the 92 per cent recorded during autumn last year.
Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade, with a couple of exceptions this year when hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic.
NHS England figures show hospitals across the country were 92 per cent full last December, amid the winter months when hospital admissions increase.
Some 93,442 beds out of 101,598 were taken up by patients needing overnight care, on average.
Regional differences in the coronavirus outbreak mean some places are feeling more strain of Covid-19 more than others – one major hospital trust in Liverpool is already be treating more Covid-19 patients than it was in the spring.
It comes after the data used by the Government to justify a second national lockdown has come under scrutiny in recent days.
Officials are making repeated comparisons to the spring situation as a shorthand for crisis but will not explain how busy hospitals actually are.
A chart was designed to show that some hospitals – shown in red – already had more Covid-19 patients than at the peak of the first wave in the spring.
Hospitals shown in amber have more than half as many virus patients as they had then, while green indicates hospitals with fewer than half the number of patients they had at the peak of the first wave.
The chart gave the impression that hospitals were already close to overflowing.
However, while 29 hospitals are shown on the slide, the full dataset, published by NHS England, actually includes 482 NHS and private hospitals in England.
At least 232 of which (and probably more as some entries were left blank) had not a single Covid-19 patient on October 27.
Mr Johnson’s top advisers also warned on Saturday that hospital admissions for Covid-19 and the numbers of beds filled by coronavirus patients are surging and the NHS could run out of room by December, unless any action was immediately taken.
Medics fear the numbers of people needing care for Covid-19 will become so large that they won’t be able to treat people with cancer and other serious diseases.
Sir Stevens said today: ‘We’re adding as much capacity as we can in anticipation of not only coronavirus but the extra winter pressures that always come along at this time of year.
This chart was designed to show that some hospitals – shown in red – already had more Covid-19 patients than at the peak of the first wave in the spring
For while 29 hospitals are shown on the slide, the full dataset, published by NHS England, actually includes 482 NHS and private hospitals in England at least 232 of which had not a single Covid-19 patient on October 27
‘And in fact the reason we want to try and minimise the number of coronavirus infections and patients is not only because of the excess death rate that implies, but because of the knock-on consequences it has for other services, routine operations, cancer care and so if we want to preserve those other services so that the health service can continue to help the full range of patients we need to do everything we can together to keep the infection rate down for coronavirus.’
Officials say the ‘available capacity’ of hospitals is only around 20,000, prompting startling warnings they could run out of room by next month.
But even during the spring, almost 40,000 beds were empty because tens of thousands of beds went unused after hospitals turfed out patients to make room for an overwhelming surge in Covid-19 patients that never fully materialised.
GREEN LIGHT FOR NHS ROUTINE TESTING
The head of the NHS in England has suggested that all patient-facing health service staff will soon be given routine Covid-19 tests.
Sir Simon Stevens said new tests and increased capacity mean that testing for all frontline workers – regardless of whether they have symptoms – should begin within six to eight weeks.
Routine testing of NHS staff is already taking place in the hardest-hit areas.
Sir Simon said that, so far, 70,000 staff in those regions have been tested in recent weeks.
The chief executive of NHS England told BBC Radio 4’s Today programme: ‘Routine testing of asymptomatic NHS staff has now begun in high prevalence parts of the country, areas where there are outbreaks, and more than 70,000 NHS staff have had those tests within the last several weeks.
‘And the chief medical officer, Chris Whitty, yesterday wrote to the Health Committee, to Parliament, explaining that, because the availability of testing had now increased, and we’ve got this new saliva testing that will be available for hospital and other health service staff over the next six or eight weeks, we will now be able to press on routinely testing all patient-facing NHS staff.’
On Monday, Sarah-Jane Marsh, the outgoing director of testing at NHS Test and Trace, suggested that routine staff testing would occur on a weekly basis.
The NHS has kept hold of the thousands of beds it commandeered to fight off the first wave, with nine make-shift Nightingale facilities on standby to help cope with a second surge of Covid-19.
It is not clear how many more beds could be made available if the NHS needed them.
The NHS England chief executive admitted today the health service did not run out of critical care capacity during the first wave.
Sir Simon Stevens said: ‘We fully expect that will continue to be the case, and indeed the action Parliament is considering today will mean not only that, but should mean that we will not need to embark on a national deferral of routine operations across the country and instead will continue with targeted local decisions based on the particular pressures individual hospitals and geographies are facing.’
There is no data to show how full hospitals really are; neither the Government nor NHS bosses provide regular updates of what proportion of beds are full or how many beds are still available.
Instead, they offer a weekly report on how many Covid-19 patients are being treated at each trust and a once-a-month update on how many of the overall number of beds occupied are taken up by the infected.
At the most recent measure – during the first quarter of 2020/21 – the NHS had a total of 118,451 beds available, of which 92,596 were general hospital beds. Only around 10,000 are currently occupied by coronavirus patients.
The total number of inpatient beds that could be called upon – including those rented from private hospitals and those in make-shift Nightingales – is unknown.
Mr Johnson and his advisers warned in Saturday’s briefing that admissions are on track to exceed levels seen in the spring crisis within weeks, heading for more than 30,000 inpatients by the end of November and more than 4,000 new admissions per day in the first week of December.
However, coronavirus data for all of England now shows that the number of people in hospital with the disease dropped on Sunday for the first time in a month, falling from 9,213 to 9,077.
Daily admissions also fell on Saturday – the most recent data – from 1,345 new patients on Friday to 1,109 on October 30.
Oxford University’s Professor Carl Heneghan, a vocal critic of lockdown policies, today said the outbreak is ‘flatlining’.
NUMBER OF COVID-19 PATIENTS IN CRITICAL CARE BEDS HALF OF WHAT IT WAS IN THE SPRING IN WALES
The number of coronavirus patients in Wales needing critical care is less than half of what it was during the peak of the virus despite rising hospital admissions, the chief executive of NHS Wales said.
Dr Andrew Goodall said early intervention by doctors, aided by increased testing, and improvements with oxygen therapies meant that both demand on intensive care units and mortality rates were lower compared with April.
Demand for critical care capacity in Wales is 60 per cent lower than at the peak, with 57 people currently receiving treatment, while 1,275 people currently occupy hospital beds because of Covid-19 in non-critical care areas.
The number of Covid patients occupying non-critical hospital beds is just nine per cent lower than it was in April and is the highest amount since that time, with numbers expected to rise further in the coming days.
But Dr Goodall said increasing admissions were not resulting in greater demand for critical care beds, saying the numbers were ‘lower than expected’ and represented ‘a good sign’.
He told the Welsh Government’s Covid-19 briefing on Tuesday: ‘By now I would have expected, if it was the first wave’s experience, to have seen more coronavirus patients in our critical care areas.
‘I think that’s a good sign, of course, because we don’t want patients to be in critical care with coronavirus. We want them to be supported and to be able to be discharged home safely and back to their family arrangements.’
Dr Goodall said using oxygen treatments instead of putting patients on ventilators was proving a ‘more effective’ way of treating patients compared with the first wave of the virus.
That, added to early interventions, was also leading to lower death rates compared with the peak not just in Wales but across the UK.
‘With the high level of testing that is going on across Wales at the moment, it does mean we’re identifying people with coronavirus earlier,’ Dr Goodall said.
Dr Goodall said the next ‘two or three weeks’ would be important for the NHS in anticipation of Wales’s 17-day firebreak lockdown having an effect on the number of hospital admissions.
But he warned that if transmission rates and admissions continued to increase, it could lead to the health service becoming ‘overwhelmed’.