What happens when the hospitals reach capacity?

[rainytreeleaves]

Just reading about NI nearly reaching bed capacity and a few places in the north as well. Hospital in Londonderry saying they are in a worse state than in the spring.

The hospital that I work in has been on black alert all week. The covid ward is full, no other wards can be repurposed as everywhere is full and (from tracing they believe) community transmission and via asymptomatic staff, there is a mass outbreak on our care of the elderly ward. Lots of staff self isolating so unsafe shifts and lots of patients infected. Also those elderly patients aren't now leaving to free beds up and no elderly patients can be admitted there for specialist input. It's a total mess.

Our local nightingale can't open as they don't have anyone to staff it. They are literally begging people throughout our region to go on the bank to staff it but there's not enough trained staff available.

I'm just not sure what will happen next....we are worse now than the spring. Slightly less covid so far but much greater bed need in general and more general transmission throughout making working really difficult.

@StatisticalSense

Well if it's staffing issues it looks like it's time for the government to conscript nonworking and part time nurses and doctors of working age to work full time (or make up their hours to full time) in the nightingale hospitals at usual rates of pay.

I'd love to be treated by a doctor or nurse who was only there because the government had forced them into it.

Also, what are you gonna do if they refuse? Get the army to march them to the hospital at gunpoint?

@Ecosse

I’d like to see all NHS staff put on emergency contracts enabling them to be transferred around the country with 48 hours’ notice.

We cannot have nurses sitting idle in Exeter who could be staffing Birmingham nightingale.

There will be no money left to fund the NHS if there’s another lockdown so we need to push NHS capacity to the max to prevent that.

Of course the government should put all childcare and accommodation in place for staff instructed to temporarily relocate.

Does this include the ones that are being conscripted and/or having their contracted hours forcibly increased?

SOME parts of the Uk ARE close to where we were in March.

BBC NW was reporting on Friday how hospitalisations in the region were at the same point as they were on 20th March and they were expecting them to be higher than the peak in a couple of weeks. The fear is the winter peak in the NW will be twice the April one and is potentially only 6 weeks away.

The NW wasn't as badly affected in April as some other parts of the UK, but that this doesn't mean this won't be a real issue if we hit the numbers being suggested.

Well said @MiniTheMinx

That whole post is just nonsense @MiniTheMinx. The economy is not some abstract concept- it is people’s jobs, businesses and livelihoods.

The economy has a direct impact on people’s health- there were 800,000 chronic health conditions caused by the 2009 recession.

Unemployment not only affects adults, but also damaged the life chances and therefore life expectancy of DC in that household.

The people who will die from suicides, domestic violence and homelessness caused by lockdown will be on average significantly younger than COVID victims with much longer to live.

This naive idea that we can just shut down the economy with no effect on health is dangerous nonsense. Even Nicola Sturgeon who is too COVID-focused for my liking admitted this last week.

We could not afford to continue funding the NHS in its current form after another lockdown either.

Partly because the NW doesn't have as many hospital beds per head of population as London does.

Ecosse, it was austerity that caused hardship and some 800,000 chronic health conditions. Austerity was a deliberate decision to bail out the banks and let us pay for it. The Tory party were in negotiations as far back as 2007 with American health insurance providers. They have been privatising services since they came to power.

I understand the economy is not some concept, but

is people's lives and jobs.

So, could you explain why your right to secure employment and a secure financial situation should trump the rights of nurses? why is it ok to demand nurses up sticks to work in other regions so that you get to carry on as normal?

@RedToothBrush

Partly because the NW doesn't have as many hospital beds per head of population as London does.

My goodness, that's a worry. London certainly didn't cope during the first wave so if the NW has even less capacity, it doesn't bode well. Over 6,200 Londoners died - many because of lack of treatment (the London Ambulance Service had to raise it's threshold for hospital admission). Awful if it also happens elsewhere.

Mind you I always question the claim about capacity. London has about nine million people living there. I struggle to believe there's anywhere close enough beds there. Particularly when you take into account the huge transient population it has including migrants (many under the legal radar), international travellers, and students.

To answer the OP.
What will happen is we'll see what should've been avoidable deaths.

What concerns me is are we causing our own issues? And it’s a genuine non medic person q!!

Our local hospital are seeing a rise in cases but have stated that actually most of them are asymptomatic, there for other reasons and it’s generally because they are testing everyone.

So by increasing their need for isolation, isolating staff, reducing bed space etc. Etc. Are we not reducing our capacity when realistically if we were treating the virus symptomatically NOT on a dodgy PCR test we actually wouldn’t have the same issues?

And the case rises in the community, I totally believe as there at around 10 positive in my DDs school. And my entire ex’s family tested positive (so 7 people) including their very frail old dad. Yet no one Poorly enough to need any treatment at all...

And I love seeing people laughing that conscription wouldn’t happen. The government has currently chucked the rule of law out of a window. So it absolutely could happen.

@DilemmaDerby
What do you think happens when the asymptomatic patients pass on their infection to patients (or hospital staff) who do get symptoms? The vulnerable cancer patient for example? They're not isolated for their sake. It's to protect the other patients and staff. Viruses can spread like wildfire in hospitals.

That’s why I’m genuinely asking the Q though.

Would it not be more sensible to staff the Nightingale’s and have them as Covid only if that’s possible? Don’t have them in the main hospitals at all, would be a bugger to reorganise the system but if it were possible.

Re hospital beds potentially running out.
It's going to keep happening if we continue focusing on individual regions one at a time - and wait to take action only after things get out of hand.

Targeted testing only in selected areas adds to the problem. It means we don't find out how bad things are anywhere until the hospitals start filling up. The time to find out is before it gets to that stage, so that we can do something to prevent it ever getting that bad.

This distracting division tactic is not helped by the mischief making media - who seem to relish in stoking division and resentment (and confusion).

I've said it before and I'll keep saying it. We need a national approach, and we need to take proactive rather than reactive measures.

Conscription would not happen. The doctors and nurses would just go off sick with stress.

And then what?

Ridiculous

@DilemmaDerby

That’s why I’m genuinely asking the Q though.

Would it not be more sensible to staff the Nightingale’s and have them as Covid only if that’s possible? Don’t have them in the main hospitals at all, would be a bugger to reorganise the system but if it were possible.

It would be more sensible yes. Our problem is we failed (unlike many other countries) to organise a well functioning test, track, and trace system. Unfortunately that means patients and staff are coming in to hospital and unwittingly infecting other patients and staff before they can be moved. We really need to urgently sort that out.

I think the other problem is sourcing the staff for the nightingales. If we genuinely have only a few parts of the UK affected (with our testing shambles, who knows?) we could perhaps see if staff - at least those without young children to care for at home - from areas with low number of cases would be willing to temporarily transfer?

The big problem is if cases continue to rise across the UK - however we might be able to prevent that with a coherent and joined-up national approach to restrictions.

Beds will be prioritised for the patients who have the strongest chances of surviving and/or dependents. Deaths will increase and the media will omce again be featuring interviews with bereaved families, with particular focus on those who have lost younger family members. This coverage will resemble footage from a dystopian horror film, but will eventually get the message across to the hard of thinking that maybe some things are more important than their "right" to socialise.

It is going to be very hard for everyone, especially NHS staff and carers. There are no easy solutions and whatever action the government takes it will be criticised for not acting swiftly enough/making lockdowns too severe/not severe enough/keeping schools open or shutting them down. We can only try to keep transmission down until there is a vaccine, and that means we all need to do our bit.

I feel great respect towards all the HCPs, carers and NHS support staff who are all doing vital work. I can't find words that will be of any real use to you, but just want to say that I am very appreciative of all the work you do.

The problem with moving staff to different parts of the country is that most hospitals are at full capacity during the winter.

@DilemmaDerby

And I love seeing people laughing that conscription wouldn’t happen. The government has currently chucked the rule of law out of a window. So it absolutely could happen.

People are laughing because all it would see is most people in the NHS handing their notice in and then there would be a worse situation. Unless you are talking of some sort of national service which would see all members of society being drafted in to provide healthcare then everyone would be affected rather than just current NhS staff.

@stairway

The problem with moving staff to different parts of the country is that most hospitals are at full capacity during the winter.

This.

There is no one sitting idle in any hospital. March....maybe. We will never be there again. There will never be a time now when people are being admitting in their droves even if we stepped down some services.

@DilemmaDerby

That’s why I’m genuinely asking the Q though.

Would it not be more sensible to staff the Nightingale’s and have them as Covid only if that’s possible? Don’t have them in the main hospitals at all, would be a bugger to reorganise the system but if it were possible.

There's no staff for the nightingales though. That's the problem. They've built them as PR but staff has to come from current NHS staff and there isn't enough to spread even thinner across another bunch of hospitals. They also have a low ceiling of care so anyone who needs NIV / intubation can't go there (my local one anyway - although it's never opened) and needs to stay in the main hospital.

I'm shocked by some posters on here suggesting medical and nursing staff can be moved around and treated like a commodity. They are professionals who go above and beyond in 'normal' times. They are not paid their worth, and now it's suggested they can be ordered back to work or moved around the country away from their own families and homes. I left nursing years ago for a reason (well many reasons including poor pay and conditions and not being valued). If the people in this country want a well staffed NHS ready for emergencies they need to value it.

I’m on my way to work now. Most of us have a sense of dread of what’s to come and are still shattered from the 1st wave. 2 of my colleagues died in May of Covid- infected at work, both isolating from families in hospital accommodation, it was heartbreaking. Do you think they sacrificed enough ?@StatisticalSense
We’re in a horrified daze tbh. Much more and people will resign.

It is actually sickening that some posters have so little respect for NHS workers that they think we should be ordered when and where we have to work yet I expect when they or their loved ones require medical care, they would expect us to do everything with a smile, compassion, dignity and respect. Well it goes both ways.