‘The public has a right to the truth’: NHS staff speak out on coronavirus fears

Exclusive: ‘The NHS is so strained at the moment it wouldn’t take many cases to seriously compromise our ability to deliver safe care,’ intensive care doctor says

The health service lacks the beds, staffing and resources to cope with a serious outbreak of the coronavirus, The Independent has been told by senior doctors and nurses.

NHS staff from across the country warned hospitals are already unable to cope, with patients being looked after in spill-over wards and waiting hours for a bed, with one doctor saying it was already a “one in, one out mentality” for intensive care.

Other staff reported delays in lab tests, rationing of protective masks and equipment, and a lack of isolation areas for suspected coronavirus patients.

Suggestions from the health secretary Matt Hancock that the NHS would use “home ventilation kits”, and that an extra 5,000 intensive care beds could be created, were labelled “fanciful” by the chair of the British Association of Critical Care Nurses today.

Nicki Credland said: “If you already have a system running at 100 per cent capacity, the idea you can get a significant amount of additional beds is just not realistic. There simply aren’t enough beds for them. We will need to make difficult decisions about which patients are going to be admitted to intensive care.

“The general public have a right to the truth.”

“It will be a real ethical dilemma for staff. We will need to make difficult decisions about which patients are going to be admitted to intensive care.”

She added: “I don’t know what Matt Hancock meant by home ventilation. It isn’t possible for people who are acutely unwell.”

One A&E doctor in the east of England said their hospital had already run out of protective respirators, adding: “On Monday the hospital was full, all escalation areas fully bedded down and patients waiting over 12 hours in A&E for admission. And this is before we’ve even contemplated dealing with a single coronavirus case.”

He added there was a “genuine apprehension about how unprepared we are. The NHS is so strained at the moment it wouldn’t take many cases to seriously compromise our ability to deliver safe care. Even if fears about potential case numbers are massively overblown it really wouldn’t take very many cases needing hospital treatment to have the system crumbling.”

A medic at the Royal Lancaster Infirmary shared an alert to staff there on Tuesday that said the hospital was short of 63 beds at 8.30am with 11 patients waiting in A&E, two intensive care patients in recovery areas [instead of a ward] and eight patients to be admitted for surgery. The messages urged doctors to “expedite discharges as a priority”.

The medic said: “This is not particularly unusual to be honest.”

The president of the Intensive Care Society, Dr Ganesh Suntharalingam, told The Independent there was a potential for “disparity” between hospitals in their ability to expand critical care services with larger units better able to weather any impact.

He said: “If demand increases dramatically, we will all have to use other hospital areas and resources in atypical ways. Staffing is an issue and, as in any major incident, staff from different teams may need to work together to deliver the best care possible”

He said it was important that regional and national systems were in place to coordinate efforts, with hospitals working together in the event of an outbreak “so that no patient is ever denied the right care when there is a single bed left anywhere in the country. We are very clear that the decisions of who to admit must remain ethical and equitable as always.”

A consultant at the University Hospitals of Nottingham Trust said the hospital had declared an internal incident on Tuesday this week with 130 patients in A&E and 40 waiting for a bed. He added sarcastically: “We are fantastically well prepared for coronavirus.”

One manager in the northwest said face masks and other equipment were starting to be rationed due to concerns over a lack of supply.

An intensive care doctor from London added: “There’s no denying we are very full indeed. It’s essentially a ‘one in, one out’ kind of mentality.

“As it stands on a daily basis we have to make some very hard decisions as to who we can admit, and who we can’t. My worry is, that these decisions are only going to get harder and more frequent.

“It’s like the scene in Austin Powers where the man is standing in front of the steam roller. It’s very slowly coming towards us, we know it’s going to happen, but we can’t stop it, and it will crush us.”

Some nurses and doctors were concerned about being able to cope if large numbers of their colleagues became sick or had to stay home to look after children in the event schools were closed. They added: “I’m not sure what NHS organisations can do, but someone certainly needs to think about childcare if we are going to keep our nurses and doctors coming to work.”

Speaking on BBC Breakfast this morning, and asked about the NHS’ ability to cope, the chief medical officer said: “The NHS will always cope because the NHS is an emergency service that is very good at adapting to what it finds itself with.

“If this turns into a very large epidemic, then it will put very high pressure on NHS and that is one of the reasons we have a very clear strategy made up of four, which the prime minister laid out yesterday to contain this virus.

“But if it can’t be contained, to delay into the summer months or late spring when it is easier for the NHS to cope with it. To do the research necessary to have the best treatments available and then to mitigate. And mitigate means getting the NHS and wider society ready for several weeks which could be very difficult.”

A spokesperson for NHS England said: “As the chief medical officer has said, as coronavirus expands, the NHS will flex its response in line with well-established escalation plans. Hospitals have been advised on what next steps they need to take to respond to any outbreak.

“Hardworking staff are working round the clock to test and treat patients with coronavirus but the public can also play their part by following health advice, including washing their hands and covering their mouths when they cough or sneeze. If anyone is worried about symptoms, they can use the new 111 online service for help and advice on coronavirus.”