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Patients are dying in hospital corridors and going undiscovered for hours, while others who suffer heart attacks cannot be given CPR because of overcrowding in walkways, a bombshell report from the Royal College of Nursing (RCN) on the state of the NHS has revealed. So many patients are being cared for in hospital corridors across the UK that in some cases pregnant women are having miscarriages outside wards while other patients are unable to call for help because they have no call bell and are subjected to “animal-like conditions”, said the RCN. The RCN warned that patients were “routinely coming to harm” and in some cases dying because vital equipment was not available and staff were too busy to give everyone adequate care. Dr Adrian Boyle, the leader of Britain’s A&E doctors, said the nurses’ testimonies on which the report was based were so horrendous that it “must be a watershed moment, a line in the sand” and must prompt the government to redouble its efforts to get the NHS working properly again. Boyle, the president of the Royal College of Emergency Medicine, said: “I am shocked, appalled and so saddened that this is the level of care we as clinicians are being forced to provide to our patients – people who turn to the NHS and its staff when they are most vulnerable and in need.” The RCN’s 460-page report, based on “harrowing” descriptions given by 5,400 UK nurses of their experience of working in hospitals, sets out how: Patients have died on trolleys and chairs in corridors and waiting rooms in settings where “all the fundamentals of care have broken down.” One nurse had seen “cardiac arrests in the corridor with no crash bell, crash trolley, oxygen, defibrillator … straddling a patient doing CPR while everyone watches on.” Patients are being given drugs, intravenous infusions and, in one case, a blood transfusion in corridors which are cold, noisy and too cramped to allow them to have loved ones present. One nurse had to tell a patient he was dying as other patients were wheeled past and orders were shouted across the unit. They said, “How is it fair to tell someone they are dying in a corridor?” Lack of space means patients also being treated in storerooms, car parks, offices and even toilets. The report came as Wes Streeting, the health and social care secretary, was forced to defend the government’s record on the NHS in an urgent Commons debate about the intense pressures this winter that have left many hospitals overwhelmed in recent weeks. Streeting responded to Conservative attacks by telling MPs that corridor care “became normalised in NHS hospitals under the previous government. It is unsafe, undignified, a cruel consequence of 14 years of failure on the NHS and I am determined to consign it to the history books.” But, he added, while ending corridor care was the government’s ambition, “I cannot and will not promise that there will not be patients treated in corridors next year. It will take time to undo the damage that has been done to our NHS.” Read the RCN report: On the frontline of the UK’s corridor care crisis Read full story Source: The Guardian, 16 January 2025

A decade-long failure to address urgent repairs in hospitals across England has led to a dramatic rise in issues posing a “high risk” to patients and staff, ministers are being warned. The cost of dealing with this backlog has almost tripled since 2015 in real terms, to £2.7bn this year. High-risk repairs have been the fastest growing part of the lengthy maintenance list over that time. It includes issues that could lead to serious injury to both staff and patients, or to major disruption of services or “catastrophic failure”. The NHS lost more than 600 days – or 14,500 hours – of clinical time because of infrastructure failures in the last year, according to a new analysis seen by the Observer. The total maintenance backlog has now ballooned to £13.8bn in 2023-24, an 18% increase from last year. The figure is more than the NHS’s entire capital budget for the year. Read full story Source: Guardian, 28 December 2024

A hospital in the South East today declared a level of critical care alert meaning that it may be forced into ‘refusal or withdrawal of critical care due to resource limitation’ because it has been ‘overwhelmed’ — but later claimed it was an ”administrative error”. Data from an internal NHS dashboard for critical care, seen by HSJ, showed today Darent Valley Hospital, near Dartford in Kent, declared it was at “CRITCON level four”. CRITCON level four declarations are extremely rare. In guidance they are known as “Triage - emergency” and defined as: “Resources overwhelmed. Possibility of triage by resource (non-clinical refusal or withdrawal of critical care due to resource limitation).” The definition continues: “This must only be implemented on national directive from [NHS England] and in accordance with national guidance.” Dartford and Gravesham Trust, which runs the hospital, replied to HSJ more than five hours after it was contacted, and after publication of the story, to say: “This was a purely administrative error which was quickly rectified.” The level has not however been changed so far on the live dashboard, HSJ has confirmed. Read full story (paywalled) Source: HSJ, 7 January 2021

Concerns are mounting over the number of coronavirus patients being admitted to hospitals in London as another NHS trust in the capital issued an urgent warning over its oxygen supplies. On Tuesday afternoon, the North Middlesex University Hospital Trust warned clinicians the numbers of coronavirus patients it was treating “was putting a strain” on the oxygen system, sparking several alarms. The trust currently has around 200 patients using oxygen with the trust consuming 2,400 litres of oxygen a minute. It normally uses around 1000 litres a minute and has a limit of 3,000 above which the system could cut out. It is only the latest hospital to face the problem – which is caused by the sheer demand for oxygen by sick Covid patients, which is more than the hospital piping can physically deliver. Read full story Source: The Independent, 30 December 2020

A major incident has been declared in Essex amid fears the number of COVID-19 cases could overwhelm the county's health services. The Essex Resilience Forum (ERF) said "growing demand" was putting stress on hospitals and social care settings. On Tuesday Mid and South Essex NHS Trust placed all three of its hospitals on critical alert. All of Essex is in tier four and the south of the county has some of the worst-affected districts in England. Essex Police Chief Constable BJ Harrington, who is co-chairman of the ERF, said declaring a major incident allowed it "to seek further support from the government to address the severe pressures which the health system is under". The forum said the number of patients being treated for Covid in the county had exceeded the levels seen at the peak of the first wave and "these levels are likely to increase further in the coming days". The ERF - comprised of health services, blue light responders and councils - said issues included "critical care and bed capacity, staff sickness/self-isolation levels and the system's ability to discharge patients quickly into safe environments". Mr Harrington urged the public to continue only dialling 999 or attending A&E in an emergency. Read full story Source: BBC News, 30 December 2020

One of England’s largest hospital trusts has been forced to divert ambulances and cancel operations, after seeing a very steep increase in covid-19 admissions over the past week. Whipps Cross Hospital in north east London, part of Barts Health Trust, declared a critical incident over the weekend, the trust has confirmed. The trust has also declared a “high pressure phase” of covid response. A well placed source said Whipps Cross had been forced to divert ambulances in recent days, because of pressure on its emergency services, while a message to staff said it was deferring some planned operations, along with other steps aimed at protecting safety. It is also understood to be attempting to further speed up discharges from hospital. Read full story (paywalled) Source: HSJ, 16 December 2020

The most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ. The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS. Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that: Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak. Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring. The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for. As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ. The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base). However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556). However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards. Read full story Source: HSJ, 23 October 2020

A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned. NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested. The home secretary defended the system, saying capacity was increasing. The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes. One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made. She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said. "I have to say I burst into tears. I was meant to be seeing patients and I feel guilty." Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work". She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day. Read full story Source: BBC News, 14 September 2020

Plans for up to 150 new community diagnostic hubs to tackle the NHS’ ballooning diagnostic waiting lists are included in NHS England ‘blue print plans’ leaked to HSJ. The document pointed out the hubs “were highlighted in the phase 3 letter [from Sir Simon Stevens] and will be recommended as part of new service models for diagnostics in the forthcoming [Sir Mike] Richards’ Review of Diagnostics Capacity”. It said “at least 150 community diagnostic hubs should be established in the first instance (broadly equivalent to the number of acute hospitals)” although it appears many of these may be temporary facilities. The phase 3 letter said systems should mange the “immediate growth in people requiring cancer diagnosis and/or treatment returning to the service by… the development of community diagnostic hubs” among other measures The Richards review was commissioned by NHS England in 2019 as it had long been recognised that England has one of the lowest levels in Europe of diagnostic equipment as well as a shortage in facilities and staff. Last month think-tanks warned of significant worsening of cancer outcomes because of the backlog in diagnosis and treatment created by a fall in referrals during the pandemic..." Read full story (paywalled) Source: HSJ, 4 September 2020

The shipment of 400,000 gowns from Turkey which was part of a delayed consignment of personal protective equipment (PPE) has been impounded in a warehouse after falling short of UK standards. The personal protective equipment (PPE) was flown into the UK by the RAF last month, arriving three days late, but has been held in a government warehouse near Heathrow since, the Daily Telegraph said. During mid-April, when coronavirus deaths in the UK were at their highest, the NHS required 150,000 gowns each day. Cabinet minister Brandon Lewis said the gowns were “not be of the quality that we feel is good enough for our frontline staff”. Speaking on Sky News, Mr Lewis said: “Well when we’re securing PPE from around the world you do it based on a set of standards that you’re looking to acquire to, but obviously once it’s here we check that it is good enough for what we want to use and in this instance some of this PPE turned out not to be good enough.” “I think it is right that if we have got particular standards for what we want our frontline staff to be able to have access to we make sure we stick to that. If something isn’t right, if we’re not even sure about it then I think it is better to be safe and not use that product and stick with products we are confident are the right products and the right standards.” Read full story Source: ITV News, 7 May 2020

Military personnel have criticised the NHS for its “appalling” handling of distributing personal protective equipment. The armed forces are helping with the distribution of equipment and staff have been seconded to help planning across seven hubs. A senior army source lambasted the health service for its logistics for PPE, alleging that masks, aprons, gloves and other items were being assigned to hospitals without regard to relative need, leading to oversupply in some areas and shortages in others. Read full story (paywalled) Source: The Times, 22 April 2020

Dozens of NHS trusts fear running out of disposable gowns this weekend if they do not receive more supplies, while national officials have issued guidance on alternatives to use in extreme circumstances, HSJ has learned. Several well-placed sources in procurement reported widespread concerns, more severe than so far in the COVID-19 outbreak. One had information that at least 60 trusts would run out this weekend without supplies, and that it was likely the large majority of NHS providers were affected. One well-placed source told HSJ the situation today was “not normal even during this pandemic”. Another described the “critical” shortage as “a dire situation for everyone”. Read full story Source: HSJ, 17 April 2020

None of the new life-saving mechanical ventilators ordered last month to cope with the increase in coronavirus patients has so far been awarded safety approval. Models by manufacturers such as Dyson have yet to get the green light from the Medicines and Healthcare products Regulatory Agency, the Financial Times reported. It comes a month after the Government issued a rallying cry to put non-medical manufacturers such as Dyson on a "war footing" to make additional machines. The lag is thought to be due in part to changing clinical understanding of how best to manage the virus. Read full story (paywalled) Source: The Times, 14 April 2020

GPs are advising patients with respiratory diseases to buy oxygen privately amid shortages of the gas across the NHS. Last week hospitals were warned to urgently consider limiting how many patients were given oxygen simultaneously. Hospitals usually have a pipeline to pump liquid oxygen from a central store to the wards, but most do not have the capacity to meet the demand from the number of patients they are treating with COVID-19. Read full story (paywalled) Source: The Times, 12 April 2020

Shortages are dogging the fight against the coronavirus. At Bradford Royal Infirmary (BRI) it's still only possible to test six staff for the virus per day, consultants have been making their own personal protective equipment, and there's an urgent need to save oxygen. Searching for ways round the problem, Dr Tom has been working with Leeds University on a 3D-printed valve that could be attached to the hospital's ventilators to reduce the amount of oxygen they use. But he also began looking at CPAP machines used to treat sleep apnoea at home. These maintain air at a continuous pressure, inside a mask, to keep the user's airways open - they have to be repurposed to provide oxygen for use in the hospital, but they use much less of it than standard hospital ventilators. They said, 'Yes we've got 2,000, how many do you want?''' he says. "And so our plan is to start with 100 and to see whether, if we use these early enough during a patient's stay, we can prevent people deteriorating and needing to go on to the more complex ventilators, and needing to come to the intensive care unit." We've been testing them over the weekend, and there's evidence from China and from the US that they seem effective. They just help inflate your lungs and that seems to be beneficial. They are also very simple, which means that there's no need for a huge amount of training. Read full story Source: BBC News, 7 April 2020

London trusts have been warned not to expect deliveries of gowns from the national supply chain for at least the next few days, HSJ understands. Without central deliveries, providers risk running out of gowns ahead of the Easter weekend. Trusts will have to rely on existing supplies and any new stock they procure independently. Staff performing or assisting aerosol-generating procedures on confirmed or suspected covid-19 patients should wear gowns, according to the latest guidance from Public Health England. But supplies have been an issue for weeks, with trust procurement leads raising concerns about dwindling gown stocks last month. It recently emerged that gowns were not included in national pandemic stockpiles, unlike other forms of personal protective equipment like masks and gloves. Read full story Source: HSJ, 9 April 2020

Plaid Cymru Leader Adam Price has argued that the Welsh Government should appoint a procurement tsar to get to grips with Wales's serious shortage of COVID-19 testing kits, personal protective equipment (PPE) for frontline health and care staff and medical devices for patients. Wales is currently only testing 1,100 people a day when it was planning to test 6,000. This follows the collapse of an alleged deal between the Welsh Government and private company Roche which would have provided for 5,000 of those tests. Adam Price made the case for the appointment of a tsar whose "sole responsibility" would be the procurement and supply of COVID-19 tests, PPE, and oxygen and medical devices for Wales. He cited cases of care homes with just one or two boxes of surgical masks - each enough to last just two days for one patient, as well as hospital staff being forced to wear paper underwear over their hair due to the lack of any other protection. Read full story Source: Plaid Cymru Party of Wales, 6 April 2020

Adult social care services are to receive millions of personal protective equipment products following a national audit of personal protective equipment (PPE), HSJ can reveal. The government will deliver more than 30 million items to local resilience forums in the coming days, for distribution among social care and other front-line services, according to a letter seen by HSJ. The stock should not be sent to acute trusts or ambulance services, the letter, from health and social care secretary Matt Hancock and housing, communities and local government secretary Robert Jenrick, stated. Describing an “urgent need” for PPE in front-line services, Mr Hancock and Mr Jenrick asked local planners to distribute this latest batch of stock “only where there is a clear and pressing need”. Read full story Source: HSJ, 6 April 2020

The government has ordered an urgent national audit of personal protective equipment (PPE), body bags, swabs and infection control products, HSJ can reveal. Local resilience forum planners were earlier this week asked to share stock levels and daily consumption rates of the items at ambulance, acute trusts and in primary care and other services by 9pm on Tuesday. They were asked to indicate whether each figure represented a “major” or “minor” supply problem, or no problem at all, in an email seen by HSJ. As well as trusts, resilience forum staff were asked to share stock levels among adult social care services, numbers of mortuary staff, other local authority staff, police, prisons, fire and rescue services and funeral directors. The email also asked planners if local services had access to PPE supplies above their immediate need and whether local authorities were in discussions with any private PPE suppliers. The email noted the Department of Health and Social Care wanted to develop a “systematic days of supply picture” for all PPE at all providers. Read full story (paywalled) Source: HSJ, 1 April 2020

A breathing aid that can help keep coronavirus patients out of intensive care has been created in under a week. University College London engineers worked with clinicians at UCLH and Mercedes Formula One to build the device, which delivers oxygen to the lungs without needing a ventilator. Continuous Positive Airway Pressure (CPAP) devices are already used in hospitals but are in short supply. China and Italy used them to help Covid-19 patients. Forty of the new devices have been delivered to ULCH and to three other London hospitals. If trials go well, up to 1,000 of the CPAP machines can be produced per day by Mercedes-AMG-HPP, beginning in a week's time. The Medicines and Healthcare products Regulatory Agency (MHRA) has already given its approval for their use. Read full story Source: BBC News, 30 March 2020

National and regional NHS chiefs will seek to share out scarce ventilators to ”areas with the most immediate need, on a fair share basis relative to patient ventilation need," they have told hospital chiefs, who are increasingly concerned about what they will receive and when. Many are expecting demand for ventilated beds to outstrip what they have as the number of patients seriously ill with covid-19 ramps up. Trust leaders yesterday told HSJ they were growing increasingly worried about the lack of information over when the machines would be sent to their trusts. Some are worried London, and other regions which see their demand spike first, will get more supply. A letter from NHS England and Improvement to trust chiefs late on Wednesday told them that as “extra ventilators become available we will coordinate distribution via regional teams who will work with local health systems”. Read full story (paywalled) Source: HSJ, 27 March 2020

The government says a communications mix-up meant it missed the deadline to join an EU scheme to get extra ventilators for the coronavirus crisis. Ministers were earlier accused of putting Brexit before public health when Downing Street said the UK had decided to pursue its own scheme. But No 10 now says officials did not get emails inviting the UK to join and it could join future schemes. The party's shadow Health Secretary Jonathan Ashworth said: "Given the huge need for PPE, testing capacity and crucial medical equipment including ventilators, people will want to know why on Monday ministers were saying they had 'chosen other routes' over the joint EU procurement initiatives but now they are claiming that they missed the relevant emails. "We need an urgent explanation from ministers about how they will get crucial supplies to the frontline as a matter of urgency." Read full story Source: BBC News, 27 March 2020

If there is a public inquiry over the handling of the coronavirus, the provision of personal protective equipment (PPE) to front-line staff could be a major theme. The government has been put under major pressure by staff over the past four days because of delays to the delivery of vital equipment. This left them at risk as they dealt with a flood of covid-19 cases described as “all-consuming” by one hospital chief executive (while another major trust declared a critical incident). The last two weeks have prompted a mammoth effort from local and national procurement teams to make sure clinicians have the PPE they need. But, sadly, the bigger picture was what the Health Care Supply Association called a “system” failure (although it did not blame staff). Numerous trusts, some of them very large, have turned to alternative suppliers to source this vital kit, in some cases spending hundreds of thousands of pounds. The situation has apparently been so dire in recent days that, over the weekend, the HCSA asked DIY shops to donate their PPE to local trusts. Read full story (paywalled) Source: HSJ, 24 March 2020

Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity. In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak. According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said. The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. Read full story Source: HSJ, 24 March 2020

The government has bought 3.5 million coronavirus antibody tests — with more widespread testing of NHS workers coming “online soon”, the health secretary has said. Matt Hancock also told a press conference this evening that a new testing facility had been opened in Milton Keynes as the government aims to “ramp up” the number of antibody tests — which will determine whether people have had the virus and can therefore return to work. Mr Hancock also said the government had shipped 7.5 million pieces of personal protective equipment over the last 24 hours, following major shortages, and confirmed the conversion of east London’s Excel centre into a huge temporary hospital facility, with between 500 to 4,000 beds. Read full story Source: HSJ, 24 March 2020