NHS leaders have been accused of downplaying the impact of the Covid crisis and putting hospitals under scrutiny for declaring critical incidents and postponing surgeries.
A leaked email urges hospitals to use the “correct terminology” and make NHS leaders aware when declaring their status.
Sources said the message was a “thinly veiled threat” and that there was “subtle pressure” amid the rapid spread of Omicron.
At least 24 trusts have declared critical incidents this week, including one in Northamptonshire on Friday afternoon, while new figures show a 59 per cent rise in staff absences in just seven days.
Trusts in London were told hospitals will be scrutinised for declaring a critical incident if there is “doubt” over the decision, according to an internal email sent from NHS England on Wednesday.
In light of media coverage, it would be “valuable” to “raise awareness of the key terminology and encourage you to ensure that you are clear ... when considering a declaration,” it said. “National scrutiny on the declaration on incidents has heightened ... and [senior managers] will need to make additional enquiries where there is doubt as to the status of an organisation’s incident.”
Shadow health secretary Wes Streeting said: “We know that the NHS is under enormous pressure and it is important that local trusts are able to be honest and open with parliament and the public about the challenges they’re facing. We are increasingly concerned that ministers are more interested in covering up problems than solving them.”
Daisy Cooper, the Lib Dem Health spokesperson, said: “This is an insult to every health worker who has given their all, and every patient with cancelled appointments and delayed surgeries.
“We must trust health chiefs when they say a situation is critical. Every NHS patient and health worker can see for themselves that this is a health service struggling under the full weight of the Omicron wave. They need support, not suspicion.”
One trust source said the email came across as “bullying” and another in the Midlands said there was “subtle pressure” from NHS England not to declare incidents – although hospital sources in other parts of the country said NHS England had been supportive.
Another NHS source from a trust in the north of England, where the number of hospitalised Covid patients is now approaching the peak of the second wave, said the message seemed like a “thinly veiled threat”.
NHS England explained in its email that a critical incident happens when “the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed, or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions”.
A major incident – the next level – is anything that “presents serious threat to the health of the community” or causes a level of casualties which would require special arrangements.
In a statement, an NHS spokesperson said: “It is absolutely right that organisations use the definition of an incident consistently across the country, so appropriate support and mutual aid can be put in place as required and so patient care can be maintained, and to suggest that this email was sent with any other purpose is wrong.”
Concerns have also been raised that trusts are facing pressure from NHS England to continue planned operations, with hospitals leaders saying they are facing difficulties in standing down non-urgent services.
Senior hospital sources have warned NHS national and regional directors are putting pressure on them to “deliver” and maintain elective care despite soaring staff shortages and have accused leaders of trying to “manage the message”.
One trust chief said: “We are finding we’re having to go through a lot of processes to stand down elective work and even then we’re not stepping it down completely.
“Some trusts are just doing it under the radar because they feel they’re not going to get support but we’re here on the ground we know best what the situation is.
“The emergency command and control position [from NHS England], is more about managing the message rather than actually providing practical support.
“The thing that really shocks me is how little is being said about these issues, we’re constantly focusing on the numbers of people being infected and not actually how many people waited and were harmed as a result of not getting an ambulance, how many GP surgeries are not able to offer a routine service, how many patients are sitting in hospital who shouldn’t be there.”
“It really surprises how little is being said. It’s the way the regional and national communication teams are behaving in trying to keep provider executives out of the media, because perhaps they’re being led by the Department of Health and Social Care and don’t want this message out there.”
A senior source at a NHS trust in the East of England said: “There are probably more trusts on the cusp of critical incident declaration than is being let on. Maybe there are a significant number now on the cusp, who have already pressed the button internally... and for whatever reason this has not been announced locally.
“The situation across the NHS feels pretty tense, not only in terms of the pressure on services, but the pressure on trusts to deliver.”
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