North London hospital warns staff to prepare for Covid surge

A major north London hospital has warned it could see the numbers of coronavirus patients on its wards triple in just a fortnight as it has been forced to cancel “the vast majority” of routine operations.

A report for senior doctors at the North Middlesex University Hospital, seen by The Independent, has revealed the scale of the challenge facing the trust, which had 163 Covid-19 patients on Tuesday, equivalent to 36 per cent of all its available beds.

The trust is only the latest in the capital to announce significant pressures with several London hospitals declaring major incidents in the past week as cases of coronavirus surge.

In an email to clinicians on Tuesday night the deputy medical director, Victoria Jones, told staff their modelling of expected Covid demand was going to get a lot worse in coming days.

NHS England has warned the capital could run out of beds within the next couple of weeks if the spread of the virus and the rates of admission to hospital don’t slow down.

Dr Jones told staff: “The actual admissions are mirroring the predictions in the model very closely and if this continues our number of Covid inpatients will have tripled by Monday compared to a fortnight ago.

“This means that we have had to take some difficult decisions quickly over the last few days. These have included stopping the vast majority of elective work, making changes to ward areas and asking staff to change their working patterns.”

She said extra staff would be brought in to help over the Christmas period.

According to the modelling, the trust will see 272 patients admitted with the virus by Monday 28 December, up from 100 on the 17 December.

In her email, Dr Jones revealed some staff had queried why the trust had not declared a major incident and had not diverted ambulances to other hospitals.

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She said: “Unfortunately, our surrounding hospitals are under similar pressure and so we cannot divert ambulances to them. The emergency department have done an incredible job of managing the volume of patients who are attending with Covid-related symptoms. There are occasions where we can request a short term (1 hour) divert to stabilise the emergency department.

“The Covid incident plan has been in place since last week and provides a similar structure to a major incident plan. Our colleagues at surrounding hospitals are supporting us with critical care capacity.”

Queen’s Hospital, in Romford in Essex, has been battling with a major incident there for more than seven days and has cancelled most operations and outpatient appointments until 11 January.

At North Middlesex Hospital, multiple extra wards have been designated for Covid patients in recent days with surgical theatres opened for patients including a makeshift critical care unit for eight patients.

Dr Jones said a rota was being created for senior doctors to support those teams having to decide on whether patients were admitted to intensive care over the coming days.

She added: “Once again I am so impressed by the ‘can do’ attitude of everyone and the sense of camaraderie and team work.

“I am aware how tired everyone is and asking you all to go above and beyond at what would normally be a time to rest and recuperate seems a big ask. However once again the medical workforce have excelled themselves in volunteering to work additional shifts or work in a different area than expected.”

One clinician at the trust told The Independent the message was clear that the hospital was struggling and the situation was bad, as was the case across London.

The latest hospital data suggests across England the NHS could see more patients on wards than during the peak of the first wave within days.