The Struggle in UK Hospitals

 by Muhammed Sahil

We all know hospitals have been struggling during this period with the rising of cases but what’s really changed.

Winter time is always a difficult time for the NHS. As well as Covid being an issue, we have to bear in mind that it is the peak season for flu, meaning that patients usually face long waiting times for care/ambulances but now hospitals have to deal with the extra pressure of preventing the spread of coronavirus between patients.

This year has had various adjustments such as:

* In order to help prevent the spread of Covid, there’s less space for beds in order to create greater gaps between patients;

* An increase in critical care beds and patients has lead to more rigorous staffing;

* Greater infection control - this includes cleaning and wearing PPE (personal protective equipment ), which takes up time for staff;

* Wards have been divided into 3 areas consisting of patients with coronavirus, those waiting for their results and lastly those who’ve tested positive. 

Collectively this means hospitals have much fewer beds along with fewer patients. In terms of stats, The NHS hospitals in England have around 7000 fewer beds available than usual. To begin the second day of the new year, there were 57,725 daily Covid cases in the UK. This new record tells us a lot about what’s on the hands of the NHS at the moment. 

Additional data shows that in December/early January  hospitals had an occupancy of around 87% and increases to just over 90% in London and the south east. Therefore according to this data, it means that for every 10 hospital beds available, about 9 had a patient in them on any given day in the UK. However interestingly the occupancy rate is actually lower than a normal winter where the occupancy tends to be between 93% - 95%. Despite this, the NHS reminds us not to make no comparison as hospitals are being run very differently. Lastly these occupancy values don’t tell us how much the workload has increase through the moving of more staff to intensive care areas. 

One problem which hospitals will not want to face is 100% occupancy and the recommended advice is that an optimum level is around an occupancy value of 85%, in order to reduce the risk of staff being overloaded / having to deal with a sudden increase of patients. Since the start of December last year, the number of patients in the UK hospitals with the virus increased by 800 which had then hit a record of 22,534 on New Year’s Day.

The rise of cases has then gone on to effecting staff leading to them having to take time off work due to either having to self isolate or due to sickness. Even the state of their mental health may have led to some staff taking time off work. Data has shown that there’s been a 2.7 % increase of staff being absent from the first wave in April (6.7%) In comparison to the year before that where it was 4%.

Elective operations 

Further problems have also risen in many hospitals in regards to elective operations which have all but stopped. But what does this mean?

Sadly it means that patients e.g. who have a brain tumour may have to have their operation delayed meaning that until the rescheduled operation occurs, patients will still suffer from the symptoms which could in turn lead to death or life changing symptoms which could have easily been avoided if treated earlier. According to a study in Lancet Oncology it has been predicted a number of over 3000 excess deaths from colorectal, oesophageal, breast and lung cancer within the next 5 years. Everyone knows each patients deserves to be treated equally with the uppermost care but when in a situation like this, a patient who will die of the next few months or years due to a tumour spread is less likely to cause uproar/dispute than the death of a patient with the virus who’s in need in of ICU (intensive care unit) care. In addition the death of a cancer patient is arguably less distressing than the death of another patient with coronavirus especially for the healthcare staff. Patients dying rapidly which could be treatable under normal circumstances  is likely to be more distressing than a patient dying from a slow ongoing condition but then again some will say every life is equal and witnessing a death of a patient regardless of whether they had the virus or not, is in itself very upsetting and emotionally difficult to undertake. Despite this problem, when human resources are low the spirit of the healthcare workers is what matters most in order to deal with the situation in the best way possible.

As you can see there've been various struggles within hospitals which may not have a clear solution yet and with the rising number of cases along with the winter season, this will continue to worsen. Experts have also suggested that a vaccine may be available in the spring/summer although certain high risk groups may be allowed access to the vaccine earlier. So for now this means that we just have to wait and see what the government can do to improve the situation.