Patients wait more than 24 hours for a bed and nurses ‘at breaking point’ in London’s busiest Covid hospital

Patients at one of London's busiest hospitals have been forced to wait more than 24 hours for a bed as A&E doctors and nurses – said to be at “breaking point” – urged bosses to declare a major incident.

The number of coronavirus patients at the Royal London Hospital in Whitechapel has increased by 200 in a matter of days, with the situation reaching a crisis on Sunday night when the hospital was forced to open a new ward and treat adult patients in a paediatric ward, although management stopped short of declaring a major incident. 

Frontline staff at the hospital, which is one of the lead NHS trusts in the capital for treating Covid patients, described ambulances queuing for hours outside A&E, with some sick patients travelling to the hospital by taxi after hours waiting for an ambulance.

The hospital sent out several major incident appeals to staff to come in on Sunday and Monday as well as urging consultants to review patients for discharge as dozens of patients waited for beds to become free.

One clinician from the hospital’s A&E department told The Independent: “We tried to get management to declare a major incident. Ambulances were waiting three hours to offload patients, and adult patients were being treated in the paediatric department because there was no room.

“We ran out of space [by] early evening and patients had been waiting in the department for over 24 hours. We had patients who waited hours for an ambulance but got a taxi in the end and they were so unwell.”

The worker, who spoke on condition of anonymity, added: “This is a classic rising-tide major incident. The threat [of a major incident] on Sunday night did alleviate things and we converted two more wards to Covid, but I have never in all my years seen anything like this. It’s worse than March or April.”

They added that they didn’t believe the hospital bosses were fully aware of what was happening: “After we told them, the ball got rolling and the order went straight away to turn the wards around and beds appeared fairly quickly. We just didn’t need it to get to that.

“I think it’s much worse at other hospitals. We are lucky because we are bigger, but nurses are at breaking point.”

On Tuesday, the Barts Health NHS Trust confirmed it was treating 638 Covid patients, an increase of 200 from Christmas Eve.

There are 139 patients with confirmed Covid-19 in intensive care. 

It has also sent a reminder to staff about the need to reduce oxygen use amid concerns over the ability of pipes in hospitals to deliver the volume of oxygen needed.

Several trusts have been forced to issue warnings to staff over concerns that the demand could cause the oxygen systems to cut out.

The trust has been expanding the numbers of beds, including critical care beds, but this has put pressure on staffing levels, particularly for nurses. It has told nurses they will be paid more for shifts worked this week to try and encourage staff to take on extra hours.

Earlier this week a nurse at the hospital told The Independent that nurses were regularly having to work 12 hours shifts without breaks because of the demands from Covid-19 patients.

As with many hospitals across the capital, the Barts Health Trust has cancelled operations and redeployed staff in efforts to support the volume of sick patients on its wards.

In a statement, the trust urged patients to continue to seek help when needed but confirmed that it was seeing significant pressures.

“We are treating very high numbers of patients with Covid-19 across our hospitals, and in line with our winter escalation plan we have moved into a ‘very high pressure’ phase and are taking steps to keep our patients safe.  

“The bespoke critical care unit at the Royal London Hospital reopened to Covid-19 patients in October and is crucial to the plans we developed with our partners in northeast London. We opened up a further ward at the Royal London on 27 December specifically to care for patients with Covid-19. This was a planned decision in line with our escalation plan.”

It added: “Like other London providers, and to help us manage the high numbers of patients we are seeing, we have stood down routine planned care and redeployed staff to critical care and Covid wards. This means postponing all elective operations, many outpatient appointments, and some diagnostic tests.”

It has also converted face-to-face outpatient appointments to virtual ones throughout December and January to limit the number of people coming into hospital.