Cancer patients at one of England’s largest hospital trusts have had their surgeries cancelled after rising numbers of coronavirus patients, which senior medics said was “affecting all our wards everywhere.”
Leeds Teaching Hospitals Trust said it had seen a “marked increase” in Covid admissions and was now having to cancel surgery for urgent patients “who’ve already waited too long”.
In an email to senior doctors on Wednesday morning, the trust’s clinical directors said: “Four patients with cancer are about to be cancelled today with very difficult and upsetting conversations. In critical care we’ve had six extra admissions, from four to 10 just yesterday.”
The Leeds hospital message, leaked to The Independent by concerned staff, said two of the hospital’s Covid wards were now full, adding: “It’s highly likely that we’ll need to open another Covid ward this week.
“We’ve got too many inpatients to manage this increase within [emergency specialty medicine] and the outlier numbers are very high – it’s affecting all our wards everywhere.”
Outliers are patients who are placed in wards away from the specialty looking after them because of a lack of beds.
The message, written by the trust’s clinical directors, also described the trust’s emergency departments as being “overwhelmed” with over 100 patients more than the usual average daily levels each day, with patients facing eight-hour waits.
The message warned: “This is unmet need and cancelling surgery makes it worse.
“This is July – it is unprecedented for us to be in this position.”
The message underlines the concern among NHS hospitals that rising infections are still leading to patients needing hospital treatment. While rises are at smaller numbers than in previous waves of the pandemic, they appear sufficient to destabilise certain services.
Health secretary Sajid Javid has said the country must “learn to live” with the virus and warned that infections could reach 100,000 per day later this summer. Chief medical officer Chris Whitty described the NHS as an “emergency service” that would have to cope.
NHS bosses fear the impact of the summer wave on the NHS could mean many more operations being cancelled, adding to a waiting list of patients already at more than 5 million.
Labour’s shadow health secretary Jonathan Ashworth responded to the development saying Sajid Javid needed to outline a plan to help the NHS cope this summer.
He said: “Sajid Javid’s plan that could see infections rise as high as 100,000 a day will mean more hospital admissions knocking on to delayed treatment, cancelled operations and longer waits for patients. Indeed it’s alarming that this is already happening with worring postponement of cancer care.
“The new health secretary urgently needs to outline a plan to help the NHS cope this summer.”
Already in recent weeks A&E departments across England have recorded record levels of attendances with patients facing long waits to be seen, and numbers far in excess of previous “winter crisis” levels. The Royal College of Emergency Medicine has estimated the NHS could be short of 16,000 beds for patients.
The Yorkshire Ambulance Service has also seen a substantial jump in 999 calls. Leaked data shows the number of 999 calls was 23 per cent above the expected levels with 3,700 999 calls. Category 1 calls, the most serious life threatening situations, were up 37% against the forecasted demand.
One member of staff said: “It's across the board. It's not just us either, all ambulance trusts are feeling the same. It’s as though the public have spent last year clapping for us and this year decided they want to see if we’re as good as they think.
“We don't know why this is happening so we can't fix it. The workforce are all shattered and there's no end in sight. Much as I'm desperate for restrictions to go I can only see the increase in workload causing service failure. We're on a knife edge, 100 more calls a day would be enough to make us fall over.”
At Leeds hospital, senior doctors were on Wednesday exploring what steps they could take to alleviate the pressure on the trust. All patients at the trust will be reviewed by a consultant today to see if they can be safely discharged.
The email said: “The thinking is – if we all discharge one extra patient today then the elective patients will get their operations. We only need 15-20 extra beds. This must be possible and we need your expertise to do it.”
Actions being taken at the trust today include senior consultants checking junior doctors’ plans for patients. Consultants are checking if requests for imaging and investigations of patients “are absolutely necessary” and whether patients could be seen as outpatients.
The email added that managers would be guided by consultants as to what was “safe,” saying: “If we can increase the number of discharges, we’ll have acute patients in the right beds. We’ll have enough space for Covid patients and we may avoid the surge out of 111, we won’t need to open more wards, and we won’t need to redeploy people.
“Please let’s work together to get the hospital flowing properly and making sure all our patients are safe, not just the ones in our acute beds.”
Matthew Taylor, head of the NHS Confederation, said: “Health leaders go to great lengths to cope with whatever the pressure that’s on them and when a hospital like Leeds has to essentially tell its staff that it isn’t able to cope, it tells you where we’ve reached. This is not a form of communication that any health service leader would make lightly and I think that the rest of the health system will look on what is happening in Leeds and completely understand and may even be going through a similar situation themselves.”
Dr Phil Wood, chief medical officer at Leeds Teaching Hospitals Trust, said: “While every patient’s care is important to us, we have had to postpone some planned elective operations to ensure patients who require urgent treatment are prioritised.
“All our cancer patients are given personal treatment plans based on clinical evidence from combined teams of senior clinicians. We are constantly reviewing the situation and we are committed to achieving timely and safe care for all our patients.”
He added: “Along with the rest of the NHS we are seeing an increase in patients admitted to our hospitals with Covid-19.
“Our hospitals continue to be incredibly busy, with significant demand for services right across the healthcare system in Leeds, including in our emergency departments.
“Drawing on experience from previous waves of the pandemic we are enacting plans to help us treat increased numbers of Covid admissions while still providing care to those patients waiting for scheduled operations.”
The trust also faced a cyber attack on Tuesday and Wednesday but this did not impact on its clinical services.
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