1/11 Some are arguing that because hospital intensive care is currently no busier than normal for majority of trusts, national lockdown isn't justifiable. See, for example this: telegraph.co.uk/news/2020/11/0…. This ignores three key issues and the argument is therefore erroneous.
2/11 Issue 1. Measuring the degree of pressure in a hospital just by looking at its ICU capacity is wrong and potentially very misleading. Hospital CEOs saying that you need to look at general and acute ward bed pressure as well as ICU bed pressure...
3/11 ...At the moment, hospital CEOs tell us that the pressure is often greater in acute and general beds and not in intensive care. This is partly because many more covid-19 patients are being treated with oxygen therapy on general wards than in the first phase.
4/11 Issue 2. NHS argument is that if hospitals have too many covid-19 patients over next two to three months they won't be able to deal with winter pressures and carry on recovering elective surgery backlogs. Those cases are usually treated in general and acute not ICU beds...
5/11 ...EG Hospital CEOs in north tell us they're having to turn general/acute beds into covid-19 beds & transfer staff to cover those beds. That's what's threatening elective surgery recovery rates & could threaten ability to cope w winter pressures. Not pressure on ICU capacity
6/11 ...Despite doing all they can to avoid this, the hospitals most under pressure are now having to start slowing down the speed at which they are recovering elective surgery backlogs. Clear evidence that higher levels of covid mean NHS can't do winter job we need it to do.
7/11 Issue 3. There is no point in using national level bed usage data to support any argument here. The pressure is highly geographically concentrated & that won't show up in any national aggregate data. Many hospital CEOs in the north tell us they are under extreme pressure...
8/11 ...Many of them say their covid-19 patient numbers are above what they saw in the peak of the first phase. Higher levels of community covid-19 infection rates also mean higher levels of staff absence, making it more difficult to provide the right quality of care...
9/11...The argument from NHS CEOs in rest of country is many are already seeing high worrying levels of general bed occupancy. And if the covid pattern in the north is repeated elsewhere in the country a month later, it'll coincide with winter when NHS is at its most stretched...
10/11 ...This means trusts won't be able to give the treatment and quality of care they would want, to all who need it. None of this is reflected in, or affected by, current national ICU bed occupancy rates. They are irrelevant as far as this risk is concerned.
11/11 The argument that the NHS is making for national lockdown therefore fully stands. See, for example, the letter we have sent to MPs today, ahead of the vote on the new lockdown regulations. nhsproviders.org/news-blogs/new….
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