The hospital and 999 chiefs have sent out an urgent warning of an “incredibly difficult” fortnight that will see testing limited services and exhausted staff in Birmingham and the Black Country.
Staff are already battling to reduce nursing levels to ‘safe minimums’ at some hospitals due to the lack of COVID isolation and illness.
Managers face daily struggles to find enough doctors and consultants while bed capacity is running at a very high level.
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Non-urgent surgeries and other alternative treatments are already being affected, and more cancellations are likely.
Sir David Nicholson, a former national NHS chief who now chairs two hospital trusts locally in West Birmingham and Sandwell and Worcestershire, said it was tough now but the next two weeks were crucial.
Speaking at a meeting of the Sandwell and West Birmingham NHS Hospitals Trust today (Wednesday), Sandwell said: “The next two weeks are going to be incredibly difficult. This virus is harsh.”
At neighboring University Hospital Birmingham Trust, which runs QE, Heartlands, Good Hope and Solihull Hospitals, operations director Jonathan Brotherton delivered the same urgent message to staff at an internal briefing this week, telling them the biggest challenge lay ahead.
About 1,800 of his employees – or 8.2% – are currently on sick leave. About 600 of them are closed due to Kovid-19.
So far local hospitals have stopped short of declaring a ‘serious event’ – a way to signal patient safety is at real risk that has already started in other acute settings around the country – but all face major challenges. Because a large number of people catch the virus.
The massive increase in community infections of the highly contagious Omikron version of the COVID-19 virus comes against the backdrop of a rapid decline in health services, with nearly one in four of all hospital patients in Birmingham now being COVID-positive.
A very sharp spike in admissions of people with the virus means hospitals in Queen Elizabeth, Heartlands, Good Hope and Solihull are now occupied by Covid-positive patients – up from just 285 a week ago. Every day around 45 patients are being admitted with Kovid-19.
It is the same picture at Sandwell and City hospitals, which now have 180 Covid positive patients – up from around 80 a week ago.
Far fewer are ending up in intensive care than in previous waves of COVID-19, believed mostly because of vaccine safety.
But with the influx of patients, an increase in staff getting sick after catching or isolating COVID-19, emergency action has begun.
In Birmingham these include:
* All 999 children are now going to Birmingham Children’s Hospital in an emergency
* A new medical ward has been opened at the Royal Orthopedic Hospital to support acute care
* Rapid community response services have been stepped up by Birmingham Community Health and virtual ward capacity has been increased to help get patients home safely.
A super surge ward – also known as a ‘mini nightingale’ – is being built at Solihull Hospital as part of a response by the UHB.
The hospital’s chief executive, Richard Beaken, said a site in the Sheldon Block of City Hospital had also been earmarked for building a new temporary ward if needed, albeit by canceling some of the optional works and freeing up those beds previously in Sandwell. Additional capacity can be found.
But whatever the plan is, the crisis is the “limiting factor” in staffing.
West Birmingham and Sandwell’s director of operations Liam Kennedy said hospitals were ‘planning for the projected increase in cases’ and there was room to further expand bed numbers – “but we are at minimum staffing levels at both hospitals at the moment.” .
“Opening up another field will be a challenge for both medicine and nursing.”
The nursing ratio in City and Sandwell is below the minimum – with only two qualified nurses per ward.
Ideas to help employees deal with or limit the crisis include:
* Temporarily increase PPE protection, by ensuring that employees wear high-grade surgical masks – the more protective FPP3 rather than blue surgical facemasks – to try to limit transmission.
* Deviate from national regulations and allow non-vaccinated workers exposed to household contact to return under the same conditions as vaccinated employees – this will minimize their time off work.
* Working closely with NHS partners to ensure that GPs and urgent treatment centers are available for extended hours to “push people away from our front doors”.
Mr Beaken said of contingency plans: “None of these are ideal, but it is important to have these plans in place.”
In hospitals in Birmingham, the UHB Trust has increased its testing to ensure a rapid turnaround of PCR tests for staff immediately.
‘Only one in ten hospitalized with Covid is caused by a virus’
New data showed that only 13% of people admitted to Sandwell and City hospitals are testing positive for Covid-19 because they are sick with the virus.
Most are not going to the hospital due to their covid infection. The vast majority have another reason for admission – those with COVID-19 are often only discovered on arrival, or caught while in hospital.
This is encouraging news – but the pressure on hospitals to manage and isolate COVID-positive patients remains the same. They have to create more ‘red’ zones to manage the infected and try to ensure that other vulnerable patients don’t catch it too, social distancing, PPE, and space are all playing an important role.
A UHB spokesman said: “Where patients are asymptomatic – also known as ’emergent’ infections – this still presents great challenges in providing the most appropriate care.” Infection prevention and control measures, preventing further transmission, loss of beds due to distance and additional cleaning, all have an impact.
Can you help?
Local health owners are urging people to seek help if they have a health concern – but choose the right healthcare service, whether self-care, GP, pharmacy, urgent treatment centre, or NHS 111. Dial 999 only in case of emergency.
They also reiterate the call for vaccination. There is clear evidence that full vaccination reduces the chances of becoming ill enough to require hospital treatment.
A UHB spokesperson said: “Having vaccines and boosters could not only save your life – it would also reduce the number of direct hospital admissions, ICU admissions and deaths, allowing hospitals to provide urgent, emergency access to patients.” And alternative care will be allowed. Who needs it.”
Jack Dromey, MP for the City of Ardington, said it is important that more steps are taken by the government to “make sure we don’t have a tidal wave of cases and infections affecting services at the local level.”
This needed to include proper ventilation in schools and more pressure on people to act responsibly by vaccinating and wearing masks. “This fortnight ahead is important.”
For the latest availability of vaccines locally, see NHS Birmingham and Solihull vaccination website here, or Black Country and West Birmingham Vaccination Website,
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