Intended for healthcare professionals


Covid-19: Hospital and ambulance services struggle with huge demand and staff illness

BMJ 2022; 377 doi: (Published 11 April 2022) Cite this as: BMJ 2022;377:o950
  1. Elisabeth Mahase
  1. The BMJ

Hospitals and ambulance services in England are facing “extreme pressures” and a high volume of staff absences, forcing some to declare critical incidents and others to warn of 12 hour waits for patients in hospital emergency departments.

Portsmouth’s Queen Alexandra Hospital and South Central Ambulance Service both declared critical incidents on 6 April, with the hospital warning, “Our beds are full and our emergency department remains full with patients requiring admission . . . We are only able to treat patients with life threatening conditions and injuries.”1 The ambulance service reported a “large volume of calls being received throughout the day and into the night and increased challenges in releasing some of our ambulances from busy acute hospitals.”2

The pressure is not just being felt in southern England. In the north, where covid cases are rising, hospital trusts across West Yorkshire and Harrogate have warned of waits of up to 12 hours in emergency departments. On 5 April the West Yorkshire Association of Acute Trusts, which encompasses six hospital trusts, reported a 14.2% higher number of attendances than in the same week in 2021.3

With emergency departments around the country inundated, ambulances have been increasingly delayed. In the week ending 3 April 26.9% of arrivals were delayed more than 30 minutes, the worst performance on record. The previous record was just over 18% in the week ending 6 January 2019.

In the week to 6 April an average of 71 088 staff in acute care trusts in England were absent each day because of sickness. Of these absences, 40% were related to covid, and this proportion was even higher in the South West (52% in the week to 3 April).4

On top of staff shortages, hospitals are struggling to discharge patients. The number of patients staying in acute care despite no longer meeting the criteria rose to just under 13 000 in the week to 3 April, the highest so far this winter.5

The NHS Confederation’s director of policy, Layla McCay, said, “This pandemic is not yet over, despite government rhetoric.” She added, “The government must be honest with the public about the need for people to take steps to curb the spread of covid where it is possible for them to do so. The government must also be honest about what people can expect from the NHS during this period of incredible strain.”

Have infections peaked?

The latest Office for National Statistics data show that in England the number of people testing positive for SARS-CoV-2 has remained high, with around one in 13 estimated to have had the virus during the week ending 2 April. ONS found that although the percentage of people testing positive had fallen in the South East, increases were seen in the East Midlands, North East, North West, and Yorkshire and the Humber.6

In Wales, infections have increased from one in 14 in the previous week (ending 26 March) to around one in 13. But Scotland saw a decrease from one in 12 to one in 13 over the same period, and in Northern Ireland there may also have been a decrease, from one in 15 to one in 16, although ONS noted this trend was uncertain.

Sarah Crofts, head of analytical outputs for the ONS’s Covid-19 Infection Survey, said, “While infections remain high, there are early signs in our latest data that they may no longer be increasing in some parts of the UK. It is too early to say if infections have peaked in England and Scotland. We will continue to monitor the data closely.”

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