Sending London patients to Yorkshire

[DeRigueurMortis]

It's been reported that due to capacity issues in London there is a proposal to send patients to Yorkshire.

London has more beds per capita than anywhere else in the country.

The nightingales have been dismantled.

In Yorkshire the rates have been high but (depending on north/south/east/west) brought into control though harsh lockdown. Those in tier 2 have been buggered by being inundated by Covid tourism and will be tier 3/4.

So Yorkshire is on the verge of it's own disaster with less beds per person than London and being overwhelmed by London cases before the local community can get a bed in their hospital.

Is it right that this should happen?

I can see very difficult choices being made in the near future, choices that no -one will want to make.

Ah, excellent. I hope if / when cases in Yorkshire rise, people in Yorkshire are at least given equal access to them. What will happen to the patients from London when they start to recover? Will they be transferred back to London, or will they be stuck in Yorkshire, miles away from any family support, & expected to get home on their own when they're discharged? Ridiculous policy all round.

This is nothing new. ITU patients are transferred out across a network fairly often. Sometimes further if there's no capacity nearby. The distances can be vast. I know what you're saying but they will go to an ITU with space and be repatriated once better (if they recover). Bed capacity in ITU is extremely closely monitored and obviously it's not an exact science but you can vaguely tell when you will get to the point where you need to transfer out and an appropriate bed is sought ASAP somewhere with space that is unlikely to be on the brink of full capacity at that point in time. Of course they have to be transferred out further if there is no space locally. It's a nightmare to actually do and takes out a doctor (if patient is intubated) + nurse for many hours from the unit so is never done lightly. Not an easy decision but the option is there

We’re all part of one community. Living near a hospital doesn’t give you a greater right to treatment in that hospital. People will be treated as best as the nhs can, wherever it can.

And it's not a ridiculous policy. It's a life saving policy. You wouldn't find it ridiculous if the last bed in your local area's ITU network were filled momentarily before your relative needed it. You'd take any bed you could, anywhere. Regardless of whether it is London or Yorkshire.

Before Christmas wales had 10 intensive care beds left, with one hospital board having zero available, and one having one available. With the inevitable increase in the next few weeks, what do you propose we do when we have no beds at all left? Leave people to take their chances or send them anywhere that has capacity?

At the beginning of the pandemic, Italian patients who lived in Milan were sent to Sicily more than 1000 km away because they had ICU beds, and Milan none.
France and Germany sent patients to Luxembourg by train. Before denying anyone care, the impossible must be attempted

Is it right that this should happen?

I suppose they know what they're doing but, similar to Greater Manchester, cases have been very high in West and South Yorks all along, and more recently in Hull. They did go down this last week or two, but some parts seem to be on the way back up again.

Maybe it's another part of Yorkshire they're being sent to though? It's a big county

But then the alternative would seem to be 'leave sick Londoners to die because Yorkshire beds should be kept free for Yorkshire people'. Not really palatable either, is it?

@Butterymuffin exactly.

And where do you draw the line at this? Great ormond street has amazing facilities to treat many rare diseases. Should it only be for Londoners? Same with the Christie in Manchester...an nhs bed is an nhs bed. It's given to those with the greatest clinical need.

? London and Yorkshire are in the same country! We all pay taxes the same, for the same service. If there’s no capacity in one area, but spare capacity in another, of course it should be used, not kept free and somebody dies because they happen to live further away from the hospital than John down the road, who might get ill at some point.

You questions smacks a bit of ‘local shops for local people’, OP.

What I mean is, it's a hellish long way to send such ill patients. Although 100km is much worse! Is Yorkshire really the closest they can find? Why are they keeping the Nightingale hospitals "on standby" but sending patients halfway up the country? Isn't that what the Nightingale hospitals were for, London overflow of cases, & general centralisation of care? If they can't be staffed or equipped, why are they keeping them "on standby"?

@Flaxmeadow - it is a big county but AFAIK there's not many big hospitals in North Yorkshire. I think maybe three at the most? Most of them are in West & South Yorkshire, that's where most of the big towns & cities are. Much less in North Yorkshire.

Argh, 1000km, not 100km.

Is the nightingale in Harrogate being dismantled or is this what they mean by this plan?

You questions smacks a bit of ‘local shops for local people’, OP.

Not at all. I asked a question and it's a difficult one that I wanted opinions on.

I find it abhorrent that people might die as a result of a lack facilities in their area,

I equally find it abhorrent that the solution is to move those people to areas that are on the verge of the same stress but have less facilities per head to accumulate the influx.

This isn't levelling up the North is it?

I've no skin in the game other than finding this idea utterly ridiculous given the stress on all hospitals.

The nightingales can’t be staffed. I’m an icu nurse and we are relying massively on redeployed (no icu experience) nurses. You can’t work in red areas if you are pregnant/vunerable/live with someone vunerable. A few nurses are off on long term sick/stress. We relied heavily on agency staff before covid and a fair number of those aren’t coming to us at the moment as they can get better rates in London etc- I don’t blame them. We were always staffed thinly and this has just meant we couldn’t take the hit of loosing that percentage. The nightingales were a badly thought out knee jerk reaction, no one can spare the staff.

@AluckyEllie - that's exactly what I was referring to. It seems like they were a total waste of money, are they supposed to function just as units for patients that don't require ICU then? Or patients that are recovering? Or were the Nightingales just a total white elephant / vanity project that the government embarked on, purely so it looked like they were actually doing something? If only they hadn't defunded the NHS so badly in recent years.

@LemonSquirtInTheEyeOfLife I’m not really sure what they were for, I had a quick google and it says the excel had ventilators and beds for 500 patients, even at a bad nurse to patient ratio that’s 200-300 nurses needed in just that one. Also, if they were just for non ventilated patients how would you get the patients there, they would have to be assessed as suitable at an A&E surely. And ambulances wouldn’t be free to transfer patients around- as we’ve seen in the news they are all stuck queuing outside A&E!
I’m putting my hopes on the vaccine tbh, I think people are complacent/fed up now and another lockdown won’t help unless they get the army in to help police it/the roads and travelling between zones. I’ve had the first vaccine dose, so it is happening although it may not seem like it.

@Flaxmeadow - it is a big county but AFAIK there's not many big hospitals in North Yorkshire. I think maybe three at the most? Most of them are in West & South Yorkshire, that's where most of the big towns & cities are. Much less in North Yorkshire.

Yes really big hospitals in Leeds, Sheffield, Bradford and so on. Reports are saying "major hospitals", so yes it will be West & South Yorkshire

"Senior sources in intensive care confirmed there had been requests in recent days for transfers from London to several major hospitals in Yorkshire,"

It's a terrible situation because West and South Yorkshire are already underfunded deprived areas and really struggled recently too, but if the beds are spare ATM then of course they must help out, but the numbers I think are fragile up north because we've only just come out of the high numbers London is seeing now.

What awful choices for the NHS to have to make.

There are some "big" hospitals in Yorkshire as I've googled it.

Mainly in Leeds - the rest are very much regional facilities.

It's an ethical dilemma.

I also think it's very different from sending patients to hospitals for specialist treatment . It's

Hence the post.

They had bloody better not! We’ve been under restrictions since August and hospitals have had a terrible time. Our numbers have dropped for now, let staff recover before the new strain inevitably finds its way here.

This is normal. When I was pregnant with dd 14 years ago we were told we’d have to be moved to great ormond street or Newcastle as they didn’t have room in scbu for her - she was 6 weeks premature. Fortunately she didn’t need special care so we stayed in Leicester general where we started. It’s scary the idea of being moved that far as a patient but perfectly normal.

If the alternative is leaving people to die then yes of course this should happen. The real question is why have we allowed the NHS to become so badly underfunded (and how will Brexit impact on it when all the EU grants that support healthcare are stopped).

@LegoPandemic

They had bloody better not! We’ve been under restrictions since August and hospitals have had a terrible time. Our numbers have dropped for now, let staff recover before the new strain inevitably finds its way here.

How selfish! What do you propose? Let the people of London die whilst your beds lie empty? You are absolutely kidding yourself if you don’t think the new strain is all over the country already. Especially after Christmas mixing.

It's really disappointing that you're turning this into a north-south issue. Have a heart for those close to death. If Yorkshire rates go up then they too will have beds found for them elsewhere.