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Thu 22 October 2020
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While Britain struggles to tackle a rising tide of Coronavirus infections, Mark Conrad reports from an NHS frontline in need of timely guidance – and resources.

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As the National Health Service prepares for peak COVID-19 – estimated to be two to six weeks away, ministers are coming under pressure from senior staff to modify their handling of the crisis following inadvertent damage to hospitals’ capacity.

Some hospitals have warned that they are now facing capacity issues due to staff absences caused, in part, by repeated changes to Government, Public Health England (PHE) and NHS England (NHSE) guidance on handling the outbreak.

Other hospitals have also warned Byline Times that they could face severe shortages of acute and intensive care unit (ICU) drugs, as well as protective equipment, when virus numbers hit a peak. One senior hospital consultant, who asked to remain anonymous, said that their hospital currently only had enough drugs to last a week once its ICU begins to operate at full capacity.

A source said: “This is an unprecedented challenge, of course, and there is no perfect response. But there is increasing concern among staff that the Government’s on-the-hoof changes – sometimes necessary – are having adverse and unintended consequences for hospitals and their staff.”

Another source cited updated guidance on how pregnant women should respond to COVID-19 – by self-isolating for 14, rather than seven, days – as an example of the impact on hospitals.

The Government, on advice from PHE and NHSE, made the announcement earlier this week without first briefing hospitals – which led to some pregnant NHS staff vacating NHS facilities before managers could plan for unexpected absences. Some pregnant staff were also upset that their trust had not previously advised them of the change.

Today, there is anecdotal evidence that the Government’s announcement on school closures has also affected NHS capacity. Yesterday, the Prime Minister said that all schools in England would close from Friday, but that arrangements would be put in place so that the children of ‘key workers’ could remain at school. But, at present, no details of which staff constitute ‘key workers’ has been made public – and no arrangements yet put in place. The Education Secretary Gavin Williamson has said details will be published later today.

In the meantime, however, some hospital managers and consultants awoke this morning to a higher-than-expected number of staff absences so that parents could look after their children.

“These are not matters of life and death,” one NHS manager warned. “But they could become just that if we continue to lose frontline staff without being able to plan for changes. Ministers need to remember that each time they make a new announcement, there will be an impact on NHS capacity.”

Meanwhile, some hospitals are now warning that NHS supply chains will need to be expedited as they prepare for the tidal wave of acute admissions due to respiratory conditions caused by COVID-19. Byline Times understands that most ICUs still have additional capacity, but many will quickly encounter challenges once they are operating at full capacity.

The NHS’ lack of access to ventilators has been well-documented. But staff are also warning of shortages in the supply of PPE (personal protective equipment) such as face masks, protective gowns, hand gels and other essential ICU equipment such as monitors and swabs.

Worryingly, one hospital said that, as things stand, it only has access to five days’ worth of vital ICU drugs. Such issues can be addressed, of course, but managers are working hard to ensure that supply lines are not interrupted by the crisis.

Asked about hospital supplies during parliamentary questions on 18 March, Boris Johnson told MPs: “Our NHS should feel that they are able to interact with patients with perfect security and protection. There is a massive effort going on, comparable to the effort to build enough ventilators, to ensure that we have adequate supplies of PPE equipment not just now, but throughout the outbreak.”

The Department of Health and Social Care said that it had “well-established” procedures to deal with supply issues “should they arise”.

Finally, several senior practitioners this morning reminded Byline Times that, while resources and attention have been diverted to tackling COVID-19, “there is still a normal NHS to run”.

One senior source said: “My biggest problem at the moment is stopping non-urgent care. [Some] medical staff want to stop everything – outpatient clinics, operating theatre lists, cancer screening sessions – but NHS England has pushed hard to say ‘do not do that’. So there needs to be a balance. We need to remember that there are still people having heart attacks, getting cancer, getting pneumonia and more.”


Byline Times is conscious of the need for serious journalism to attribute quotes wherever possible – and we will always endeavour to do just that. However, to receive up-to-date information from the NHS frontline, we do still have to work to protect sources. Please continue to contact us with vital, helpful information during the Coronavirus outbreak. We take the view that, providing we can stand up the facts (and we always check them), anonymity for staff is often crucial.


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