‘A winter like no other’: The challenge now facing hospitals

London’s Barts Health Trust now has more than 10,000 patients who have waited longer than a year for treatment after it was forced to stop all routine care for patients in December, as the second wave of Covid hit the capital.

The trust is one of the largest hospital groups in the country and treated more Covid patients than any other NHS trust. Its Royal London Hospital, in Whitechapel, was at the forefront of the country’s response to the virus during both waves.

At a board meeting on Wednesday, directors heard details of the scale of the challenge now facing the hospital as it begins to recover its services.

Its chairman, Ian Peters, told the board the last few months had been “the most challenging period in the trust’s history due to the Covid variant. We’ve been the busiest hospitals in London, and staggeringly we were treating 5 per cent of all critical care patients in the UK.”

He warned the trust board: “We face sobering challenges ahead post the pandemic, with waiting lists of 10,000 or more for over 52 weeks and the need to give our staff time to recover being just two of those.”

A report to the board described the last few months as “a winter like no other” and said its five hospitals across east London had been “changed beyond recognition”.

In total, more than 12,000 Covid patients have been treated in the trust over the past 12 months, with more than 1,000 dying – including five members of staff during the recent wave.

The trust stood down all planned care in December and redeployed hundreds of staff to help look after critically ill patients on Covid wards. The trust report said: “All elective operations, many outpatient appointments, and some diagnostic tests were postponed for the duration.

“We postponed about 2,000 appointments when this was suspended before Christmas, and the backlog of people waiting more than a year for a routine operation treatment is over 10,000. Urgent cases are being performed on the NHS by the independent sector, using our clinicians but private premises and staff.

“Our task now is to balance maintaining our Covid-19, emergency and vaccination services; introducing a breathing space for staff to rest and recuperate; and planning a phased restoration of those services put on hold.”

At its peak, the hospital had 835 coronavirus patients in beds on 14 January – the equivalent of an entire large-sized hospital. On 19 January critical care peaked at 223 patients.

Intensive care capacity at The Royal London tripled from 44 beds to 150 at the peak of the second wave.

Trust medical director Alistair Chesser said: “We've had to reduce the amount of elective [planned] surgery at the height of the pandemic to an absolute minimum, focusing on those who need immediate surgery only. We’re now able to do some of our less immediate but still urgent surgery, either in the hospitals or in the private sector, and that will continue for the time being.

“But we’ve got a formidable challenge now getting our elective services back up and doing that in a way which addresses some of the huge demands which you can see in our waiting list figures.”

As the NHS Confederation has warned, the trust saw a significant drop in referrals during 2020 and its staff were described as exhausted and fragile.

The trust has employed a team of psychologists to support staff over the next two years and is also encouraging staff to take their annual leave in the coming months.

As part of its planned recovery the trust is looking to prioritise patients based on their clinical need and those who have faced long waits. In total it has 87,000 patients officially waiting for treatment and more than 30,000 patients waiting for diagnostic tests.