Coronavirus: Hospital cancels most operations after surge of patients

Nottingham University Hospital has told surgeons to cancel most non-urgent routine operations at its hospitals with immediate effect after “rapidly escalating demands” caused by coronavirus.

The East Midlands hospital had warned it may have to cancel surgeries earlier this week after it reported experiencing 100 admissions a day in its accident and emergency department.

A message to staff from the trusts medical director and chief nurse on Friday said the urgent action was necessary “to create capacity for emergency patients” and to support critical care services.

Children’s surgery has so far not been included in the cancellations.

The hospital said patients isolating for three days before surgery will be postponed and only those isolating for a minimum of seven days can go ahead.  

Some cancer and urgent patients may be affected by the isolation rule change but the hospital said they could be accommodated sooner in future as more routine surgeries are cancelled.

It is hoped the measures, which will be reviewed next week, will also help prevent patients bringing the virus into the hospital to allow some operations to go ahead.

The number of infections picked up by patients in the hospital, known as nosocomial infections, has forced the closure of beds to stop the outbreaks spreading further. Spread of coronavirus among staff and patients within hospitals was a major source of infection during the first wave earlier this year.

This has been a probelm alrady for hospitals in the northeast of England where a leaked report earlier this week should there were 70 outbreaks in NHS locations on Monday.

On Friday the University Hospitals of Birmingham announced it would be turning away non-urgent patients from its three A&E departments because of pressure on services with doctors warning the trust was at its limits.

NHS England has asked trusts to restore more routine services and to hit a target of 90 per cent of pre-pandemic activity by the end of this month. For hospitals in parts of northern England and the East Midlands this may be impossible.

The message to Nottingham staff said all planned surgeries that were not high priority, including at the nearby Nottingham Treatment Centre, will be cancelled until further notice and review on October 23.

The email added: “It is important to understand that although the number of Covid-19 patients at NUH is escalating quickly, the impact on the elective pathway is being seen sooner than expected due to the number of beds we have had to close due to nosocomial spread.

“We can all help reduce the impact of this and protect our elective patients for longer, by ensuring we are rigorous in following [infection prevention] guidance, including the proper wearing of masks at all times, hand hygiene, two metre distancing and adhering to the local restrictions outside of work, including avoiding any mixing indoors with work colleagues. Please reinforce this amongst your teams.”

The hospital said some surgeries scheduled to go ahead in private hospitals would be able to go ahead as these hospitals had more side rooms and were better able to isolate patients from the risks of infection.

In Greater Manchester on Friday 90 patients were in intensive care with a leaked analysis suggested the whole region could see as many as 230 patients in intensive care by the 10 November with the city following a worst case scenario trajectory.

Hospitals in Liverpool have also been hit hard by rising numbers of coronavirus patients with the intensive care unit at the Royal Liverpool Hospital said to be 90 per cent full earlier this week.

A spokesperson for Nottingham University Hospitals NHS Trust said: “Our hospitals continue to offer Covid-19 and non-Covid-19 care to patients who need it and anyone who needs treatment or is worried about symptoms should come forward for help.

“We are facing a very serious situation here in Nottinghamshire. We have the highest levels of Covid-19 infection in the country, and as a result we have had to postpone some of our non-urgent activity. We wish to make it clear that our care for those in need of urgent cancer operations, or of other clinically urgent procedures, remains.

“We ask our communities to please follow the government guidance closely – wash your hands, wear a mask and maintain social distancing. Playing your part to control further transmission in our city and county will help to save lives.”