Coronavirus: Major hospital to turn patients away as it is stretched to ‘its limits’

Bosses at University Hospitals Birmingham (UHB) Trust tell The Independent they would be “closing the front door” of its three main hospitals to non-emergency patients for the first time

One of the country's largest hospitals has been forced to transfer Covid patients elsewhere and will begin turning patients away from A&E as the rise in coronavirus cases pushes it to its limits.

In a dramatic move to try and relieve pressure, bosses at the University Hospitals Birmingham (UHB) Trust told The Independent they would be “closing the front door” of its three main hospitals to non-emergency patients for the first time.

Anyone who turns up and who has not been involved in an accident or does not have an emergency will not be treated. Instead patients will be told to see their GP, call NHS 111 or care for themselves. The trust estimates this could affect up to 330 patients a day and help prevent long delays in patients stuck waiting in ambulances because the A&E departments are full.  

It comes after hospitals in Liverpool and Nottingham warned they would have to cancel some operations again with hospitals in the northeast of England battling multiple outbreaks of Covid-19. The emergency Nightingale hospitals in Manchester, Sunderland and Harrogate have been placed on standby although there has been no move yet to reopen the Birmingham Nightingale at the NEC.

One doctor at the trust told The Independent: “We have been shipping Covid patients out of UHB to other hospitals left right and centre this week to keep our heads above water. We aren't inundated, we are just at our limits.

“It's difficult. The staff here are brilliant clinicians and they are doing a great job but it's just sensible for the public to know what it's like. The trust has to be honest with the world.”

Across the trust there are more than 210 patients with coronavirus on Friday, including 19 in intensive care. Birmingham saw 314 people test positive for Covid-19 on Thursday with the city seeing a seven-day rate of infection of around 187 cases for every 100,000 people – far less than areas such as Liverpool, where the rolling average is more than 688 cases.

A second intensive care consultant at the trust, who asked not to be named, warned services would be unlikely to cope if the trust tried to keep doing planned operations at the same time as coping with normal winter pressure and rising coronavirus cases.

The staff here are brilliant clinicians and they are doing a great job but it's just sensible for the public to know what it's like. The trust has to be honest

Doctor at University Hospitals Birmingham

“The reason we coped in the spring was because everything else was put on hold or cancelled. If we are going to try and continue with elective operations during winter with patients seriously ill with Covid, we are not going to be able to cope with all the critically ill patients. Something is going to have to give.

“We have to communicate honestly with the public. They need to understand there are consequences to their actions. Not just with coronavirus but also with alcohol, mental health issues and looking after each other. If you can avoid getting ill this winter, please do.”

They added: “Pressure from Covid-19 is ramping up. Our elective operations are running at around 75 per cent of what they were and with Covid admissions rising, it’s unlikely we will be able to do anymore than that.

“It’s not unusual for us to transfer patients when we’re under pressure; we are just about coping.”

UHB confirmed it had carried out six transfers of coronavirus patients to hospitals in Redditch and Warwick during the last four weeks.  

At the peak of the pandemic in April, the trust had more than 700 patients with coronavirus with around 170 patients in intensive care.

In a statement, the trust told The Independent: “We are seeing increased and sustained pressure on our hospitals during this second peak of the pandemic. As a result and in order to increase the intensity of our Covid response, we will be introducing measures to ensure we can continue to provide healthcare quickly, safely and sustainably to those who need it most.  

“We have committed to not returning to ‘corridor care’ in our emergency departments and cannot do so due to Covid restrictions. For this and other reasons, patients are spending unacceptably long periods of time on ambulances, which is not only a risk for those patients but also for those needing an ambulance and who cannot be reached in a timely way.

“Therefore we will be ‘closing’ the front door to those patients that can be appropriately seen or assessed in other settings such as NHS 111, self-care or in primary care. If patients present at our EDs and are not an accident or emergency they will not be seen in the hospital setting. The decision to turn people away has been reached with the support of health partners and regulators.”

The trust has not yet had to cancel any planned operations but warned surgeries would be prioritised based on “clinical need”.

The statement added: “We recognise it is distressing for patients whose elective care does need to be rescheduled, however we must always ensure that the care we provide is safe.”