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65% of English NHS trusts exceeded first wave peak for Covid patients last week

Pamela Duncan, Ashley Kirk and Haroon Siddique
·6-min read

Two-thirds of all NHS trusts across England were treating more coronavirus patients last week than they did at the peak of the first wave of the pandemic, a Guardian analysis reveals.

Figures show that in 17 trusts the number of people suffering from coronavirus outnumbered all other patients.

On the current trajectory, the number of people being treated for Covid in England’s hospitals could be double that of the April 2020 peak within weeks. On Thursday, the equivalent figure stood at 32,925, 74% higher.

Speaking on Friday evening, Prof Chris Whitty said the peak number of people entering hospital would be in the next week to 10 days for most places. England’s chief medical officer said that while they were hopeful the peak of infections had already happened in the south-east, east and London, where there was a sharp rise in the Kent variant, it would be later elsewhere.

“The peak of deaths I fear is in the future,” he said. ”The peak of hospitalisations in some parts of the country may be around about now and beginning to come off the very, very top.”

Health leaders have been warning for weeks about the potential for the current wave to overwhelm the NHS, but Guardian research reveals many trusts may have already reached that point.

The Guardian analysis also shows:

  • Six trusts, in London, the east of England and south-east, have become Covid-majority trusts (meaning that, on average last week, more than half their beds were taken up by coronavirus patients). Two others have 50% of their bed capacity taken up by Covid patients.

  • A further 34 trusts had at least a third of their general and acute bed capacity taken up by coronavirus cases last week.

  • 15 NHS trusts treated at least three times as many patients in the week to Tuesday as they did in the first wave.

Dr Rob Harwood, the chair of the British Medical Association (BMA) consultants committee, said that while its members were used to dealing with winter crises “this is like nothing we have experienced before”.

He said: “These statistics drive home what a perilous situation the NHS is in, and the impact on patients and staff cannot be underestimated.

national share

“With hospitals filling with Covid patients, ambulances are already queueing at their doors, with incredibly sick people being treated in vehicles because there is no space inside. Elective care has all but stopped, with even urgent operations in some areas being postponed.

“While all efforts are being made to increase capacity, demand is rocketing and there will come a point when we cannot stretch the existing workforce any further. This is before we consider that almost 100,000 staff are absent, around half of whom are off due to Covid.”

A total of 134 of 207 trusts in England – or 65% – had more Covid patients on at least one day last week than at their first-wave peak. The trust with the highest weekly peak when compared with the first wave was East Sussex Healthcare NHS trust, where 422 Covid patients were treated on both Monday and Tuesday – 5.7 times its mid-April peak of 74 patients.

The trust has responded by increasing recruitment of staff, including of people who have left the NHS, postponing some routine operations and suspending home births and births at its midwife-led unit, because it cannot guarantee timely ambulance response times in the event of an emergency.

The trust where there has been the highest total number of Covid patients in the last week was the Mid and South Essex NHS foundation trust, which had an average of 777 patients on any day over the last week and 2.5 times as many Covid patients on one day as during its first-wave high.

On Monday, it said oxygen supply had reached a “critical situation” at the trust’s Southend university hospital because its staff were treating more and more people with the virus.

trusts with highest increases

Other than the Nightingale hospital in Exeter, the highest Covid occupancy rate was in the Whittington Health NHS trust in London. There 63% of beds were occupied by coronavirus patients last week, an average of 145 beds, compared with 79 for non-Covid patients, with just seven unoccupied. Whittington hospital announced at the end of last month that it was suspending non-urgent adult services.

Other trusts where Covid patients took up a majority of beds were North Middlesex university hospital NHS trust, West Hertfordshire hospitals NHS trust, Medway NHS foundation trust, Homerton university hospital NHS foundation trust, Dartford and Gravesham NHS trust, Milton Keynes university hospital NHS foundation trust and Croydon Health Services NHS trust.

Chris Hopson, the NHS Providers chief executive, said: “Rising admissions rates mean trust leaders are becoming increasingly concerned about ensuring there is enough capacity – in terms of beds and staff – to safeguard the quality of care for patients.

“The number of beds in hospital occupied and those staying over a week in hospital are both continuing to rise nationally.”

Related: Covid infection numbers levelling off in parts of England

Amid concerns about the pace of vaccination of the NHS workforce and availability of appropriate PPE, Dr Samantha Batt-Rawden, the president of grassroots organisation the Doctors’ Association UK, said the wellbeing of staff “giving all” to keep patients safe must be a priority.

“The NHS is currently under enormous strain and staff are at breaking point,” said Batt-Rawden. “The number of admissions to hospitals is still increasing, with patients having to be transferred from the south to the north-west to try and free up space in ICU. This is not sustainable. Doctors have told us they feel that they are running on fumes.”

Dr Nick Scriven, immediate past president of the Society for Acute Medicine described the figures as “alarming”, adding: “Given that infection rates are still massively high, pressure will continue probably for another two to three months as we know hospital admissions lag 10 days behind infections and ICU (intensive care unit) admissions a few days more. Inpatient numbers will stay at unprecedented numbers as Covid leaves people in hospital extremely frail needing often weeks of care so admission rates can easily be greater than the rate of people leaving hospital.”

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said: “We are only just beginning to see the worst of it. It is likely that the situation will deteriorate further.”

Every region in England treated more patients in the week to Thursday than at their first-wave peak, with every region experiencing its highest-ever figure on either Wednesday or Thursday.

searchable table

The east of England is treating more than two and a half times as many people as it did in its first-wave peak, with the south-east nearing that multiple.

A recent fall in case numbers indicates that these figures may decrease in the coming weeks. Data from early this week showed tentative signs of easing admissions in London and the south-east, but subsequent data is less encouraging. Admissions continue to rise England-wide, although the pace has slowed.

An NHS spokesperson said: “Hospitals facing most pressure from high Covid-19 infection rates are receiving support from the wider NHS through Nightingale hospitals and neighbouring hospitals, as well as the independent sector.”