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.

Beds will be prioritised for the patients who have the strongest chances of surviving

Yes the 'Three Wise Men' approach.

But once someone is in a bed, they will stay in it - all clinical options have been exhausted and valid justified DNR is in place.

Thus is why the exceptionally vulnerable were asked to shield. Because they would be bed blockers - falling ill early (when beds still available) getting it seriously and needing extensive and long term intervention. And NHS does not put down inconvenient patients - it's first come first served, and once on a treatment pathway you stay until dead or discharged.

People who have RTAs, serious industrial or other accidents are basically stuffed if all ITUs are filled with Covid patients. High risk operations would have to stop, for same reason

Winter is always difficult in the NHS, the pressure on beds and services is immense over those months. This isn't a new thing brought about by Covid, it happens every year.

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

How do you suggest it is funded. What system would cost less?

Wiseup we could reduce the expense of government to pay for it? I mean it’s never happen but y’know...

My suggestion would be instead of enslaving NHS staff, we could look at ways of providing care for bed blocking patients outside of hospital. There will be many patients who don’t need hospital care anymore but can’t be sent to nursing homes as they tested covid positive or don’t have suitable accommodation or care set up. These patients could go to the nightingale field hospitals where they could receive help with basic care needs without the need for doctors and nurses to be overly involved. Members of the public looking for work / volunteering could be quickly trained up to give personal/ social care that these patients mainly need.

Temporary relocation according to business need is something that is expected in many jobs- I do not think NHS staff should be exempt at times of national crisis.

When DH was a trainee solicitor 20+ years ago, he arrived at the office on Monday to be told by a partner that he was relocating to a different office for a month from Wednesday.

As long as the logistics are taken care of, this could be a key tool in our armour- a demand-responsive home guard. An Uber for doctors and nurses.

We had minus 6 beds Friday before last with no covid patients! It’s often like this in January but not October. What’ll happen as covid picks up is our icu rooms with squeeze 2 beds in each instead of one. Patients will stay in ED for longer and patients will be discharged without full care packages in place (we really try not to do this but this is the reality). It’s a constant battle trying to get patients flowing. Worst case we can divert ambulances which is okay until the other hospitals are full too.

@sheepandcow

The NW isn't the area with the least beds per person.

That honour falls to Mid Wales I believe. Which has the added issue of being more remote.

Hence why the welsh government has intervened earlier and with a no one in or out policy.

@stairway the nightingales were set up as icu capacity so don’t have lots of toilets and bathrooms for patients, although there was talk of adding those.

@Ecosse bless your heart that you imagine anywhere in the UK is going to have the slack in the system to allow staff to be taken from one area to another, come the Winter.
It would be lovely to think that all the accidents and illnesses that ordinarily occur will simply stop because there is also Covid. The NHS has already taken a lot of flack for not providing all services during the height of the pandemic and now you want them to stop providing them again ?

@frasersmummy

There are approx 1278 hospitals in the uk.. And 4323 in hospital with covid

That works out at less than 4 cases per hospital

That's quite misleading. That figure includes all hospitals managed by NHS trusts, for example ones which offer palliative care, rehabilitation, cater for outpatients only, and also includes private hospitals which carry out procedures on bahalf of NHS. Obviously these facilities arent equipped to admit or deal with Covid cases. Compare the 1, 278 figure quoted with for example the number of Type 1 Emergency departments in England which stands at 132.

Ecosse - conscription for various jobs is probably as much effort as blockading regions and requiring quarantine to travel between.

Some health workers would leave if they were required to move job. They have very useful skills which are in great demand in private sector or abroad.

Statistical sense - are you volunteering for the nhs? Or do you actually work there?

Conscription is a way of tackling it, but I think there are other things you could do first. I think that whole country action would be effective in tackling covid - but needs to be more holistic than conscription for nhs workers. The reason people leave nhs is because of underfunding, low staffing, poor flexibility and compassion for their staff. I think the same happens for teaching.

Prevent evictions or utilities being cut off, distribute rations. Govt can make more testing labs. Compulsory purchase tests - so no private tests and people use on purely a needs basis. Public health to control who is tested. Manufacture ppe, close borders.

@SheepandCow. I agree, there needs to be National action now. I'm in the SE, it's not looking like we will be getting any further restrictions today, our numbers are lower than the North, but why wait until it gets worse?(and it IS rising here. Quite quickly!)🙇🏻‍♀️

Someone I know rang an ambulance for their dh last night, he has classic covid symptoms, still waiting for test result. Paramedeic said it's definitely covid. He's struggling to breath, however his obs were ok. He's very weak and can't walk.

Paramedic said there's no beds in the hospital. I mean maybe if his obs were ok he doesn't need to be admitted but the impression was given was that if there had been beds they'd have taken him in. He has significant pre existing health conditions.

@WiseUpJanetWeiss

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

How do you suggest it is funded. What system would cost less?

Presumably some kind of private health insurance kind of arrangement?

Private insurance would not cost less. Think about it - an extra layer of admin so that either before or after someone is treated, you need to check which insurance provider they are with, make the transaction for the amount. What do you do about uninsured (for whatever reason)? Are you going to make people pay up front and claim later? How about people who haven’t got the cash up front to do so?

@JacobReesMogadishu

Someone I know rang an ambulance for their dh last night, he has classic covid symptoms, still waiting for test result. Paramedeic said it's definitely covid. He's struggling to breath, however his obs were ok. He's very weak and can't walk.

Paramedic said there's no beds in the hospital. I mean maybe if his obs were ok he doesn't need to be admitted but the impression was given was that if there had been beds they'd have taken him in. He has significant pre existing health conditions.

That’s sad. Hope that person is OK.

If this was a month ago they’d would’ve almost certainly been admitted straight away. Early treatment, early recovery, lower Covid death rate overall. It’s when you tell people to wait at home that things can go downhill Quickly.

@MJMG2015

They could start by making half term 4 weeks and really hammering home the need to stay home! Essential shops only & as infrequently as possible etc etc.

Yes, lets do that and make working parents who can't wfh or look after kids whilst working lose their jobs!

@CloudsCanLookLikeSheep it's a horrid and terrible situation. It's really unfairly affects certain groups of people. I think there should be childcare options like last time, but it's far from ideal. However, every single option form doing nothing to full lockdown will unfairly affect certain groups. It's just a horrid situation.

Presumably some kind of private health insurance kind of arrangement?

And would that cost less, or would that cost more?

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

The NHS, can be funded by cancelling HS2for starters.

As said by Frumpty, the NHS is at capacity during winter regardless of CV and shut down all non essential ops in recent years, despite not a bad flu season....
Even if this country allowed, we do not have enough staff to move around to different hospitals & as cases increases, they d have to move back again! idiotic thinking & no comparison to a solicitor who can function pretty much on their own.

When are people going to realise that if you have a PM who doesn't take CV seriously (told us all a few weeks ago, we d be back to normal by November/Xmas) then planning is all done last minute or not at all, this is the root cause of our problems.

Even today, a govt minister (Oliver Dowding) saying we can beat CV by Xmas... are these people fucking mad?

The conscription idea is bonkers btw. How did virus take hold in care homes ? Movement of staff ...for example one in Skye part of a large chain who moved asymptotic staff from Kent.
I believe that caused 8 deaths.

@jasjas1973

Cancelling HS2 would not even scratch the surface of funding the NHS as it is a capital project with a budget spread over decades.

The annual cost of HS2 would be lucky to fund rubber gloves for the NHS for a year.

@WiseUpJanetWeiss

Presumably some kind of private health insurance kind of arrangement?

And would that cost less, or would that cost more?

I’ve got no idea. It wasn’t me that suggested it. 🤷🏼‍♀️

[quote Ecosse]@jasjas1973

Cancelling HS2 would not even scratch the surface of funding the NHS as it is a capital project with a budget spread over decades.

The annual cost of HS2 would be lucky to fund rubber gloves for the NHS for a year.[/quote]
Tax take will not reduce to nothing because of CV.

The cost of HS2 isn't spread over decades, the borrowing might be.
the first stage is supposed to be completed in 8 years time.

The point is, there is plenty of money and the willingness to borrow for vanity projects and of course no shortage of billions to fund Brexit or Tridents replacement.

but the moment tax take is threatened, its the NHS that has to be sacrificed... not any of the above.