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One of our government's 4 tests was not exceeding NHS capacity. An interesting discussion with @Kit_Yates_Maths recently with @OwenJones84, where he astutely pointed out that this hasn't been defined got me thinking about how we might go about defining this.
A few thoughts.
A few thoughts.
So when is NHS capacity overwhelmed?
Is it when we run out of oxygen in hospitals?
Is it when we run out beds despite surge capacity?
Is it when we run out of ventilators?
Is it when we start creating surge capacity by using resources from other routine care settings?
Is it when we run out of oxygen in hospitals?
Is it when we run out beds despite surge capacity?
Is it when we run out of ventilators?
Is it when we start creating surge capacity by using resources from other routine care settings?
Worth remembering surge capacity is often created at the cost of routine care - public & private. Also when we create surge capacity, the number of staff treating the patients are often still the same- it's just the no. of staff per patient has changed.
So is it then when staff are handling more patients per head than they're supposed to, at personal cost & possibly at the cost of patient safety?
Or is it even before then - when routine care is impacted?
When we have millions of people waiting for routine care as we have now?
Or is it even before then - when routine care is impacted?
When we have millions of people waiting for routine care as we have now?
Is it when our staff have been doing disaster medicine in hospitals for over a year and are exhausted, overwhelmed and traumatised?
A BMA survey showed >40% of doctors suffered with anxiety, depression or burnout
1 in 4 have sought mental health support. https://www.rcplondon.ac.uk/news/more-1-4-doctors-have-sought-mental-health-support-during-pandemic
A BMA survey showed >40% of doctors suffered with anxiety, depression or burnout
1 in 4 have sought mental health support. https://www.rcplondon.ac.uk/news/more-1-4-doctors-have-sought-mental-health-support-during-pandemic
Is it when 8 out of 10 nurses report their mental health being impacted, and 6 out of 10 report impact on their physical health?
Is it when 60% of nursing staff report burnout? https://www.nursinginpractice.com/analysis/toll-nurses-mental-health-of-covid-19/
Is it when 60% of nursing staff report burnout? https://www.nursinginpractice.com/analysis/toll-nurses-mental-health-of-covid-19/
Or is it when A&Es are so full patients have to be in trollies in corridors and HCWs have to practice 'corridor medicine'?
Is it when patients waiting for beds die in corridors?
This is an article from December 2019 - before the pandemic reached the UK. https://www.theguardian.com/society/2019/dec/10/thousands-of-patients-die-waiting-for-beds-in-hospitals-study
Is it when patients waiting for beds die in corridors?
This is an article from December 2019 - before the pandemic reached the UK. https://www.theguardian.com/society/2019/dec/10/thousands-of-patients-die-waiting-for-beds-in-hospitals-study
I don't have the answer, but aiming to stay 'just below NHS capacity' has so far meant meant -
1. >150,000 COVID related deaths to date
2. > 1 million people with long COVID
2. The longest waiting lists for routine care in history
3. Unprecedented mental health impact on HCWs
1. >150,000 COVID related deaths to date
2. > 1 million people with long COVID
2. The longest waiting lists for routine care in history
3. Unprecedented mental health impact on HCWs
Perhaps its time to redefine NHS capacity- I'd argue we had 'exceeded NHS capacity' well before the pandemic - the NHS has been underresourced for yrs and stretching it even further to the extent we have has had devastating long standing impacts on the NHS, patients, and HCWs.
Worth thinking about the value our govt has assigned to life, healthcare, and HCWs over the past year at the very least.
If we come out thinking >150,000 people dying has been a success, we have utterly failed the basic test of being a compassionate society: valuing people.
If we come out thinking >150,000 people dying has been a success, we have utterly failed the basic test of being a compassionate society: valuing people.
Note: I'm no longer seeing patients, so cannot imagine fully what HCWs/care home staff have been through over the past yr. I'm sorry if I've got something wrong- reading reports and surveys is not a substitute for lived experience & there's a lot I've almost certainly missed.
Worth also remembering that our HCWs and care home staff still don't have adequate PPE- despite all evidence, they're still not provided with the grade of masks they need to in their day to day work. Hundreds of HCWs have died, and >120,000 are currently living with long COVID.
