The NHS in England is returning to its highest state of alert amid warnings that hospitals will continue filling up with Covid-19 patients for at least another two weeks.
The service will go back to level 4 alert status at midnight on Wednesday to coincide with the start of the second lockdown.
The switch to level 4 means the NHS’s response to the resurgence of the pandemic is being handled nationally rather than regionally and that NHS England’s national incident coordination centre – comprising the organisation’s senior team – has become operational again, having been stood down in July.
It will monitor which hospitals are coming under the most pressure and decide what steps need to be taken to respond, for example by diverting patients with spare capacity and managing non-Covid care.
The number of people seriously ill with Covid who are being treated in hospitals in England has risen from 2,000 at the end of September to almost 11,000.
That is more than half of the 19,000 Covid patients whom hospitals were treating at the peak of the pandemic in April, Prof Stephen Powis, NHS England’s national medical director, said on Wednesday.
Powis said the number of people being infected with coronavirus was rising across the country. The influx is not confined to places in the north such as Liverpool and Manchester, and hospitals in the south of England are starting to fill up.
“The north-west is particularly under pressure; the highest infection rates are in the north-west. That translates into the highest number of admissions [being] in the north-west,” Powis said at a press conference. “But … infection rates are now rising and rising faster in the south, [and] hospital admissions are beginning to rise in the south of the country too. Therefore our hospitals are beginning to fill in the south with coronavirus patients.”
Sir Simon Stevens, the NHS England chief executive, admitted that the pressure on hospitals from Covid-19 was increasing so sharply that the health service could have to abandon its ambition that patients seeking normal, non-Covid care during the second wave of the pandemic should be able to get it.
“The truth, unfortunately, is that if coronavirus takes off again, that will disrupt services. We’re seeing that in parts of the country where already hospitals are dealing with more coronavirus patients now than they were back in April,” he said, citing Leeds as one place where hospitals have already had to cancel routine surgery.
Hospitals in Liverpool, Nottingham, Yorkshire and Plymouth in Devon have done the same in recent weeks.
“We’ve seen, for example, that in the north-west of England a quarter of patients who would otherwise be having their routine operations, those beds, services and facilities are instead being having to [be] repurposed for coronavirus,” said Stevens.
He pleaded with the public to help protect the NHS by following the new rules that come into force on Thursday morning, as well as the government’s “hands, face, space” infection control advice. “The reality, I think, is that there is no health service in the world that by itself can cope with coronavirus on the rampage,” he said.
What he called “three lines of defence – the actions we take as individuals and families, [and] the efforts of the test-and-trace programme” were vital to ensure the NHS was not overwhelmed, Stevens said.
NHS Providers, which represents hospital trusts, said the return to the highest level of emergency preparedness confirmed that “the health service is once again facing one of the most challenging periods in its history”.
Saffron Cordery, the organisation’s deputy chief executive, said: “Despite months of preparation for the second wave, this is going to be an extremely difficult winter for the NHS and will place a further burden on staff who have worked relentlessly since the start of the pandemic to care for patients.”
Planned surgery and cancer care may have to be scaled back to ensure hospitals can focus on Covid patients, she said. “Alongside treating more Covid-19 patients than at the height of the first wave, trusts are also providing above-average levels of cancer care and planned surgery. But this is now under threat.”