Coronavirus: Can the NHS cope with the increase in demand?

Isla Glaister and Lucia Binding
·4-min read

Ministers have accepted that the coronavirus outbreak will spread in a "significant way’" within the UK, meaning many people are likely to need hospital treatment. So can the NHS cope with the increase in demand?

There are 30 hospitals on standby across the UK which have infectious disease units that can isolate patients.

Five of those are specialist infection centres in England - The Royal Free and St Thomas', in London, the Royal in Liverpool, Royal Hallamshire in Sheffield and Royal Victoria Infirmary in Newcastle.

Most of the people who have tested positive for COVID-19 have been taken to these specialist centres - capable of caring for more than 100 patients at any one time combined.

NHS England is now on its highest emergency alert - "level four" - which means other hospitals are also preparing for extra patients.

The government's chief medical adviser Professor Chris Witty has said that critical care beds in the NHS could come under intense pressure during a coronavirus epidemic, and told MPs the UK had mainly moved to the delay stage of tackling the virus.

How many critical care beds are there in England?

Public Health England say one in every 20 coronavirus patients could need critical care, based on China's experience.

NHS England has 4,048 adult critical care beds - around seven beds for every 100,000 people.

By comparison, Italy - the European epicentre of the coronavirus - has more than 12 beds per 100,000 people, while Germany has more than 29 beds per 100,000 people.

In Europe as a whole, there are 11.5 critical care beds on average per 100,000 head of population.

Bed numbers per England region

While data shows there are 4,048 critical care beds in England and 3,038 beds occupied according to latest figures published by NHS data in December.

Critical care beds run at between 70% and 80% capacity most months, according to data from NHS Digital.

Figures vary by region, with almost 80% of beds occupied in London compared to 68% in the eastern region.

Across the UK, the bed fill rate for Northern Ireland and Wales was estimated to be at least 95%, while Scotland was 84%.

Are there enough nurses to cope with an outbreak?

Three out of five critical care units said they did not have enough nursing staff, according to a 2018 Faculty of Intensive Medical Care (FICM) survey.

Meanwhile, two out of five units had to close beds due to staffing shortages on at least a weekly basis across the UK - with only 14% of units not having to close beds.

This is expected to become a wider problem if staff become ill or have to look after relatives as the outbreak escalates.

There have also been several temporary GP practice closures across the UK, which puts more pressure on the whole health and care system and not just the response to coronavirus.

On Monday, University Hospital Southampton closed its surgical high dependency unit to new admissions after a staff member tested positive.

Shortage of supplies

Doctors are reporting of a shortage of clinical masks and surgical protection supplies - most of which are imported from China.

NHS staff say they are unable to get hold of some face masks and other specialist personal protective equipment (PPE) - required to prevent them falling ill.

GP surgeries in Wales are expected to receive packs of protective face masks, gloves and aprons this week to support their treatment of people with suspected coronavirus.

In response, the Department of Health and Social Care said it would now release the UK's stockpile of equipment set aside for when the country faces a pandemic disease - despite coronavirus not yet being classified as a pandemic.

A Department of Health and Social Care spokesperson told Sky News: "We maintain large stockpiles of a range of personal protective equipment (PPE), including face masks, and these are being released in a controlled manner to help ensure the uninterrupted supply to the NHS.

"In line with well-established procedures, the NHS is managing a rise in demand for certain types of PPE across the NHS above normal levels. There is no need for local stockpiling."

Hospital flu admissions

Despite a peak in hospital admissions for flu in December, latest UK flu figures do give some cause for optimism.

Compared to last year, the number of people admitted to hospital has been down considerably since the end of January. This means the NHS is unlikely to have to cope with a peak in cases for both flu and COVID-19 simultaneously.

Last year, NHS England coped with 6.3 million unplanned admissions.

Even if admissions for coronavirus totalled twice that of the swine flu outbreak of 2009/10 (26,000), then it would still only represent a one per cent increase.

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