Coronavirus: Kent hospitals ‘overwhelmed’ as ICU bed occupancy hits 137%

Exclusive: ‘There are people on the wards that ideally we would like in intensive care but we don’t have capacity,’ clinician tells The Independent 

Shaun Lintern
Health Correspondent
@ShaunLintern
Friday 01 January 2021 19:36
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<p>Hospitals in Kent are stretching nurse staffing to unsafe levels due to Covid pressures</p>

Hospitals in Kent are stretching nurse staffing to unsafe levels due to Covid pressures

More critically ill patients are being transferred to hospitals across England as NHS trusts in Kent reported bed occupancy levels in intensive care reaching 137 per cent on New Year’s Day.

Eleven hospitals across the Kent and Surrey regions are failing to meet nurse-to-patient staffing ratios in intensive care, raising concerns for patient safety.

Thresholds for admitting patients to intensive care are being revised, and clinicians in the region say some patients who should be in intensive care are instead being looked after on other wards because there is simply not enough space available.

It is thought the region is aiming to transfer more than 20 patients to other hospitals across England in the coming days to try and relieve the pressure.

The news comes as Britain recorded another 53,285 cases reported in 24 hours, with another 613 deaths, slightly down from a new record high of 55,892 cases reported on New Year’s Eve.

Kent patients are going as far as Bristol and Leeds, more than 230 miles away. It emerged earlier this week that some patients had already been sent to hospitals in Portsmouth and Southampton.

Data from an NHS dashboard for the Kent and Medway region shows there are 114 patients in critical care, with 55 on ventilators and only 83 beds available on the adult critical care wards, a bed occupancy rate of 137 per cent.

Data showing the scale of the challenge in critical care bed occupancy in Kent hospitals

A safe bed occupancy rate for patient care is normally 85 per cent.

Hospitals in the region have 29 “surge” beds opened up in other areas of the hospitals, but staff are being spread thin.

Nursing ratios are being stretched to one nurse for every four patients – a previously unthinkable and unsafe ratio before the coronavirus pandemic. The normal level is usually one-to-one nursing for intensive care patients.

One critical care clinician, speaking on condition of anonymity, told The Independent the region was overwhelmed and the situation was only getting worse.

They said: “Kent currently is at 137 per cent of its critical care bed occupancy and 78 per cent of all its patients in critical care have Covid. It has opened up all its surge beds and is now having to transfer patients out, 20 in the next few days.

“The wards are full of Covid and we are running out of oxygen flow and having to make hard decisions on who gets lifesaving, non-invasive or invasive ventilation. We could admit far more patients to intensive care, but we just don’t have the beds available.”

They said four of the intensive care units had now declared a “Critcon level 3” alert – one of the highest levels of alert for an ICU which means the units are at full stretch with the hospital operating at or near its maximum. Only a level 4 alert is higher and can only be implemented with the agreement of NHS England.

Several hospitals in Kent have declared alerts in their ICU departments where staffing levels are being stretched

The clinician added: “All but one ICU is meeting staffing levels and we are having to do one nurse to four critically ill patients. The wards are also busy and we have staff off sick so we cannot get extra staff just to help. Kent is completely overwhelmed.”

Asked what this meant for the care of seriously ill patients, they said: “We are not rationing as such, but there are people on the wards that ideally we would like in intensive care but we don’t have capacity.

“Outside of a Covid surge situation we would have these patients in ICU. We are having to increase our severity threshold for criteria to admit patients to ICU. We are trying our best with the large numbers of sick patients we are being exposed to.”

A spokesperson for NHS England South East said hospitals in the region have opened more intensive care beds to respond to the increased demand.

Meanwhile, senior health figures have reiterated the risk of staff burnout as the number of those requiring hospital treatment continues to rise.

Adrian Boyle, vice-president of the Royal College of Emergency Medicine, said: "Staff are tired, they have worked really hard over the summer, they have put up with a lot of disruption.

“This time people are frustrated – this is now an entirely preventable disease, we know what we did in spring made a lot of this go away. There’s also now a vaccine.

“The idea that we are dealing with something that can’t be controlled doesn’t wash. This is a preventable disease and we need to be preventing it.”

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