Hospitals critical incidents

[Spottyphonecase24]

I have seen a number of hospital trusts have declared this today. What does this actually mean and how does it affect us? Boris didn’t seem to be bothered by this should we be?

The newsreader on before the press conference said it's where need outstrips capacity.

I thought they said they were going to bring the army in? Was onlY half listening...

I wouldn’t take my cue for whether to be bothered, from whether Boris appears bothered iyswim. Politically of course he would downplay it.

They happen every winter, sometimes they only last a few days, sometimes longer. They are an official NHS term for getting help from neighbouring hospitals/alerting NHS bosses to the need for more resources

This is the definition of a critical incident from the NHS England Emergency Preparedness Resilience & Response Framework:

"A critical incident is any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions."

It is very serious to have multiple Trusts declaring critical incidents at the same time
as we do today.

In our inpatient department, 1/3 of the nurses are off with Covid. We're struggling to keep the ward safely enough staffed to stay open. Extrapolate that.

It means hospitals are struggling to function safely. This can happen at anytime and for many reasons, also not just during a pandemic.

My understanding is that staff sickness is so high that this is causing safety concerns.

Declaring a critical incident with initiate policy within the hospital, moving staff,closing certain services etc.

The nurses and doctors are stuck at home isolating because they have something nearly everyone else has.

That's the emergency.

The phrase "shooting yourself in the foot" springs to mind.

A critical incident in the NHS is defined as

"any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions."

it is "principally an internal escalation response to increased
system pressures/ disruption to services that are or will have a detrimental impact on the organisation’s ability to deliver safe patient care."

In practical terms, it means the Trusts involved can make decisions, impose strict prioritisations/triage, and ask for assistance in a specific manner centrally directed by the Action Plan, with clear lines of responsibility, in a much more directed (escalated) way than everyone struggling on independently. For example, they can co-ordinate the cancelling of services or redeployment of staff, and centrally co-ordinate communications as to what and why.

It's basically a centralised, organised way of saying "we have a big problem here, and we need to do something extraordinary to cope."

@TheNoonBell

The nurses and doctors are stuck at home isolating because they have something nearly everyone else has.

That's the emergency.

The phrase "shooting yourself in the foot" springs to mind.

I think "shooting yourself in the foot" would be more relevant to sending COVID+ clinicians into hospitals in the current context

I'm not sure why you seem to think it's an overreaction

It means the country you live in is now officially a banana republic.

"riveted1

I think "shooting yourself in the foot" would be more relevant to sending COVID+ clinicians into hospitals in the current context

I'm not sure why you seem to think it's an overreaction"

Because everyone in hospital probably already has it or will soon and the omicron is super mild. Anyone in a risk category will most likely have been jabbed so are "protected".

48 deaths today of people testing positive within the last 28 days.

To put that in perspective, 450 odd people died of cancer today, actually of cancer, not with cancer.

"Hospitals at ‘breaking point’ as winter NHS crisis deepens" - December 2019.

NHS winter crisis: hospital 'felt like something out of a war zone' - January 2018

"OPEL figures revealed a third of hospitals in December 2016 issued serious alerts about their ability to meet patient pressures."

"At least 15 hospitals are telling patients to stay away as evidence mounts that A&E departments are struggling to cope" - January 2015

Sorry, I shouldn't say this, but I'm having a true 'Boy who Cried Wolf' feeling about news today.

@lljkk

"Hospitals at ‘breaking point’ as winter NHS crisis deepens" - December 2019.

NHS winter crisis: hospital 'felt like something out of a war zone' - January 2018

"OPEL figures revealed a third of hospitals in December 2016 issued serious alerts about their ability to meet patient pressures."

"At least 15 hospitals are telling patients to stay away as evidence mounts that A&E departments are struggling to cope" - January 2015

Sorry, I shouldn't say this, but I'm having a true 'Boy who Cried Wolf' feeling about news today.

I’m having an ‘NHS has been underfunded and hampered by lack of social care for years’ feeling.

@lljkk Sorry, what is your point?

We all know that The NHS struggles every winter due to too few beds, not enough staff and chronic underfunding

This same system now has to cope with yet another huge wave of pandemic Covid cases.

Understanding that the NHS was pressured pre-Covid doesn't mean the pandemic isn't heaping even more pressure on an already fragile system.

Saying thing like 'crying wolf' just makes you sound incredibly uninformed and is frankly offensive to all those healthcare professionals knocking themselves out to care for people.

The NHS Trust that I work for has declared a critical incident a few days ago. For the hospital I work in, it means is that the number of patients requiring beds is far exceeding capacity. Also, that staffing levels are too low, and in my opinion, patient safety can be at risk. Some things that commonly happen when a critical incident is declared: An extra bed has been put in each bay on a ward (so 7 to a bay rather than 6). Staff a/l is cancelled and all staff are requested/pleaded with to do overtime. Staff are expected to take on different duties (still has to be within their scope of practice) and work in different parts of the hospital according to need. Any non-essential meetings/training is cancelled. I have to say it’s pretty exhausting working in these conditions and with the worry they patient safety can be compromised.

I can humbly say that as MNer efforts to insult me go, that was pretty tame !!

My meagre contribution is that NHS is always in sodding crisis, every winter. I can't make the most recent news useful.

In my trust it means that there are too many patients for the beds we have. Beds will be closed because there isn't enough staff to open them.
What happens is they cancel all non-emergency surgery and move those staff to acute wards.
Sometimes they cancel annual leave but I've only ever seen this happen once in march 2020.
They will put the ambulance service on divert to other hospitals but will still be open to walk ins at A&E.
They will transfer patients to other hospitals if they can.
Unfortunately most hospitals are in a similar position locally.
There's 8 of us off from my ward at present with covid or isolating due to contact with covid. Add that to the staff on annual leave, days off, mat leave and normal sickness and it's a perfect shitstorm. Our ward is officially shut to admissions but in reality we cannot close (nicu) we can just refuse transfers in.

Have any of the Hospitals reporting critical incidents opened the carpark wards yet ?

@TheNoonBell

"riveted1

I think "shooting yourself in the foot" would be more relevant to sending COVID+ clinicians into hospitals in the current context

I'm not sure why you seem to think it's an overreaction"

Because everyone in hospital probably already has it or will soon and the omicron is super mild. Anyone in a risk category will most likely have been jabbed so are "protected".

48 deaths today of people testing positive within the last 28 days.

To put that in perspective, 450 odd people died of cancer today, actually of cancer, not with cancer.

Due to the shitshow that was the third primary dose rollout, the most vulnerable are not actually fully protected yet. Why? Because they’re not boosted yet.

Third primary doses were announced on September 1st, but many (most?) didn’t get them until October. That means they’re only becoming eligible for boosters this month. Personally I’m not eligible for another couple of weeks.

So until the most vulnerable have had the chance to be boosted AND a week or two for the booster to kick in on top of that — which is mid-February — you’re talking bollocks about anyone in a risk category being protected.

@TheNoonBell

"riveted1

I think "shooting yourself in the foot" would be more relevant to sending COVID+ clinicians into hospitals in the current context

I'm not sure why you seem to think it's an overreaction"

Because everyone in hospital probably already has it or will soon and the omicron is super mild. Anyone in a risk category will most likely have been jabbed so are "protected".

48 deaths today of people testing positive within the last 28 days.

To put that in perspective, 450 odd people died of cancer today, actually of cancer, not with cancer.

Yes, and as has been said numerous times before, escalation of coronavirus transmission causes even more disruption to the healthcare of non-COVID patients.

You can't ignore coronavirus patients. They have to be treated. And if they are, that's an entire ward that needs to be seperated from vulnerable patients.

Suggesting that COVID+ clinicians should be treating these vulnerable patients instead of isolating is ridiculous.

It means you probably dont get treatment if ill,as nurses and doctors are completely overstretched and csnt cope anymore.it also means Boris Johnson doesnt give a fuck about it.

@Thatldo

It means you probably dont get treatment if ill,as nurses and doctors are completely overstretched and csnt cope anymore.it also means Boris Johnson doesnt give a fuck about it.

So true

@sparklehead

So how much worse is this time to previous times in your experience either pre covid or during previous waves?

Thank you

Government Pandemic Alert levels:

Apparently we're only at 4.

Ot basically means hospitals do not have enough qualified staff to provide safe care. So if a patient is at risk of falling or needs 2 hourly turns but a nurse has 10 patients instead of 6...the quality of care goes down dramatically despite best efforts. Staff feel awful and helpless, patients do and families understandably upset but risk of accidents and mistakes makes it extremely stressful for all