Coronavirus: Is the NHS ready for the surge in cases?

A nurse in protective wear taking a temperature Image copyright Getty Images

The NHS is braced for a surge in coronavirus cases.

Experts are predicting they will soon start rising rapidly before the impact of curbs on everyday life kicks in and starts, with luck, to suppress the outbreak.

So what has been happening and will the NHS be able to cope?

Hospitals have cleared the decks

From next month all routine operations, such as hip and knee replacements, are being cancelled for three months.

There is also a drive to get as many patients as possible who do not need to be there, discharged from hospital.

On Friday, the head of the NHS in England, Sir Simon Stevens, said: "We have reconfigured hospital services so that 33,000 hospital beds are available to treat further coronavrius patients."

NHS bosses have asked hospitals to protect cancer care, although in some places the rising numbers of coronavirus cases has meant services have been hit.

For example, the Barking, Havering and Redbridge NHS Trust has said it would only be able to carry out urgent operations.

Intensive care capacity is increasing

The NHS in England has 3,700 adult intensive care beds - a figure which rises to well over 4,000 if you factor in the rest of the UK.

At the start of March about eight in 10 were occupied.

But several hundred are occupied by patients following routine operations, so stopping those will give the NHS extra headroom.

The NHS is aiming to get up to 12,000 intensive care beds in total by sourcing extra ventilators.

A deal has already been done with the private sector to get access to 1,200 ventilators used in their hospitals, while ventilators for children are being repurposed, as old and new stocks are being gathered.

The latest figures provided by the government this week suggests there are now 8,000 ventilators available to the NHS.

How they will be staffed remains unclear. Rules are being relaxed to allow non-intensive care specialists to be paired with specialists, and staff-to-patient ratios may also need to be reduced.

What do I need to know about the coronavirus?

Big field hospitals are being set up

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In the coming weeks, a field hospital at the ExCeL Centre in east London should be up and running.

The exhibition space, which has been used in the past for events like Crufts and Comic Con, will eventually hold up to 5,000 patients.

Dubbed the Nightingale Hospital, the temporary base will be staffed by NHS medics with the help of the military.

It will initially provide about 500 beds equipped with ventilators and oxygen.

Another temporary hospital, at the National Exhibition Centre in Birmingham, with a capacity for 5,000 beds, will open in mid-April.

A 1,000-bed facility at the Manchester Central Conference Centre (formerly the GMEX Centre) will also open in mid-April.

Retired staff and volunteers helping out

Ministers have appealed to retired staff to come back and help the NHS.

Legislation has been passed reducing the regulatory hurdles they need to go through to return to work.

About 12,000 former staff in the UK have come forward, including 2,600 doctors and more than 6,000 nurses.

More than 18,700 student nurses and 5,500 final year medics will also join the NHS workforce.

Image copyright Getty Images

Health Secretary Matt Hancock has also put out a call for 250,000 NHS volunteers to deliver food and medicines. Within the first 24 hours more than 500,000 people came forward to offer their services.

The main focus of their work will be supporting the one-and-a-half million highly vulnerable people who have been told to shield themselves from any contact with others.

NHS England medical director Stephen Powis says there have been "outbreaks of altruism" and he feels "bowled over" by the responses from retired staff and the public.

Problems remain

One of the reasons retired doctors and nurses are being recruited is because of the need to cover staff who are off sick themselves.

Hospitals have already started reporting that large numbers are having to self-isolate at home because they fear they have the virus, or a member of their household does.

One of the problems is that health staff still cannot get tested. Currently it is only possible to test about 6,000 people a day and this is being prioritised for hospital patients.

However, the government is looking to increase this to 10,000 daily tests by next week and 25,000 by mid-April.

But perhaps the biggest concern is the lack of personal protective equipment in individual hospitals - masks, gowns and gloves - to prevent staff being infected.

The government has acknowledged there have been distribution problems, but says they are being resolved.

British Medical Association leader Dr Chaand Nagpaul says the situation is "totally unacceptable" and is putting the health and lives of staff at risk.

So can the NHS cope?

The driving force behind the government's measures to suppress the spread of coronavirus - including closing down schools, restaurants, theatres and pubs - has been the need to stop the health service becoming overwhelmed.

The key piece of modelling that influenced the government was done by Imperial College London, which warned that the previous strategy, aimed at only slowing the spread of the virus, risked hospitals getting swamped. It said that 250,000 lives would be lost in the process.

On Wednesday, Prof Neil Ferguson, one of the lead researchers, said he was "reasonably confident" that hospitals and, in particular intensive care units, could cope given the increase in ventilators and change in policy by ministers, although local areas could struggle. UK chief medical adviser Prof Chris Witty said it was "probably manageable".

But not everyone agreed. Speaking on Channel Four, Prof Hugh Montgomery, an intensive care specialist at University College London, said he had "no doubt" hospitals would fail to cope.

He said there would be a "tsunami" of cases coming in the next two weeks in London, and predicted units would start running out of beds.

Chris Hopson, chief executive of NHS Providers, which represents hospitals, said that at this stage, no-one could say for sure what would happen overall, but added that the health service had put itself in the best position possible, having "never done so much in such a short space of time".

With experts predicting the peak in a matter of weeks, we will soon find out.

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