London faces ‘ticking time bomb’ over oxygen supplies as another hospital issues warning to staff

Concerns are mounting over the number of coronavirus patients being admitted to hospitals in London as another NHS trust in the capital issued an urgent warning over its oxygen supplies.

On Tuesday afternoon, the North Middlesex University Hospital Trust warned clinicians the numbers of coronavirus patients it was treating “was putting a strain” on the oxygen system, sparking several alarms.

The trust currently has around 200 patients using oxygen with the trust consuming 2,400 litres of oxygen a minute. It normally uses around 1000 litres a minute and has a limit of 3,000 above which the system could cut out.

It is only the latest hospital to face the problem – which is caused by the sheer demand for oxygen by sick Covid patients, which is more than the hospital piping can physically deliver.

On Monday, the Queen Elizabeth Hospital, in Woolwich, revealed it had declared a major incident and was forced to divert emergency patients to other hospitals because demand for oxygen from coronavirus patients had overwhelmed its system.

Senior clinicians in London told The Independent the problem was being felt across the city, as the numbers of patients soars, with regional NHS bosses discussing oxygen supplies several times daily.

The number of coronavirus patients in London passed the peak seen in April, with 5,371 patients in hospital on Tuesday, compared with 5,201 on 8 April.

Across London patients, including some who are critically ill, are being transferred between hospitals to try and manage demand with operations being cancelled and staff redeployed to makeshift critical care wards set up in operating theatres and other areas.

On Tuesday, the UK reported record levels of coronavirus infections with more than 53,000 positive cases.

The latest wave of the virus now threatens to eclipse previous levels for hospital patients with the NHS in England recording 21,787 patients in hospital on Tuesday, 1,360 more than the April peak.

One senior NHS source told The Independent the oxygen problem was being felt across the city at many hospitals.

“It is a ticking time bomb”, they said, adding: “We are shuttling patients between sites to keep people safe using dedicated critical care transfer teams.

“It is being discussed three times daily with NHS England. We have known this was a problem for a while and there is no end in sight with the infections rising but everything is being done too late at a strategic level.

“The decision-making by NHS England is weeks behind where we need it to be. It is very difficult to understand who is accountable at a regional and national level.”

In a message to staff on Tuesday afternoon, Dr Emma Whicher, medical director at the North Middlesex Hospital, told staff patient safety could be maintained even if patients had their oxygen levels reduced marginally.

She said: “Once again a surge in Covid-19 patients is putting a strain on oxygen and this is something all staff can help with.”

The trust has implemented a hospital-wide reduction in the use of oxygen, lowering the target saturation for adults to between 90 and 94 per cent. Some patients who need less oxygen, such as those with chronic obstructive pulmonary disease, are already treated with less oxygen with a range between 88 to 92 per cent.

A normal oxygen rate would be above 94 per cent. The trust said it was following evidence based guidelines on the use of oxygen and safety was being maintained.

Clinicians have been told to review patients’ use of oxygen daily and to ensure unused oxygen is turned off.

NHS England warned hospitals over the demands for oxygen earlier this year after several NHS trusts were forced to divert patients when their systems failed. Watford General Hospital had to close its A&E in April.

NHS England has invested £15m on improvement works at some hospitals to help shore up oxygen systems.

Wards have also been told to watch out for the risk of fire due to high levels of ambient oxygen in the air.

Concerns over the pressure on the NHS with little official acknowledgement has sparked criticism from some including the Doctors’ Association UK, a grassroots membership organisation for doctors.

It’s president, Dr Samantha Batt-Rawden, said: “The NHS in the southeast is in meltdown. Staff on the front line are devastated that we have ended up back where we were in April, with cases increasing at a rate that shows no sign of slowing. ICUs across the southeast are overflowing, with doctors telling us their hospitals are running out of non-invasive ventilators and even basics like oxygen.”

Dr Jenny Vaughan, the organisation’s vice chair, said the silence from government was “deafening” adding: “Staff are worried about speaking out due to fear of reprisal. Lessons have not been learnt, and the mistakes of the first wave are being repeated while frontline staff are treating sick patients in more and more extreme conditions.  

“Problems faced at the coalface must be aired and not denied or covered up.”

NHS Providers, which represents NHS hospital trusts, has urged the government to take decisive action as it reviews current restrictions on Wednesday.

Its deputy chief executive, Saffron Cordery, said: “The new variant has changed the dynamics of what was already a very worrying situation. Pressures on the NHS in some parts of the country are rising at an unsustainable rate.  

“Thankfully, trusts in other areas have been helping out. But with the virus spreading fast alongside mounting winter pressures, the options are narrowing.”

She said it would be a tough decision to move millions more people to the highest level of restrictions but added: “The government must act with boldness, speed and clarity in curbing the threat of Covid-19.”  

A North Middlesex University Hospital spokesperson said: “As with all hospitals across the country, we are treating a rising number of people with Covid-19 who need oxygen to support their breathing, but we have robust plans in place to preserve oxygen and keep patients safe.”

NHS England’s London regional team were also approached for comment but did not respond before publication.