Five-fold increase in oxygen demand in hospitals – medic

Oxygen demand ‘surges FIVE-FOLD in some NHS hospitals’ as Covid inpatient numbers hover around second wave peak and January cancer ops drop by 800 amid appointment cancellations

  • ICU doctor Rupert Pearse said it is becoming ‘hard’ to get oxygen to patients
  • Leaked data shows 800 fewer cancer surgeries in the first two weeks of January
  • Still almost 50 per cent more patients being treated for Covid than April peak

Demand for oxygen has surged five-fold in some NHS hospitals, a senior medic claimed today as trusts continue to grapple with the winter wave of coronavirus admissions.

Professor Rupert Pearse, an ICU doctor in London and member of the Intensive Care Society, said that on some occasions the pressure has made oxygen – vital for seriously ill Covid-19 patients – ‘hard to deliver’.

It comes as leaked data showed there were 800 fewer cancer surgeries in the first two weeks of the year than are normally carried out, according to the Health Service Journal.

The bulk of the delayed operations were in London, Essex, Bedfordshire, and Surrey, which have bore the brunt of the second wave and have been battling the highly infectious Kent variant.

There is growing concern that pauses in cancer treatment throughout the pandemic have left many patients with a shortened life expectancy. Charities predict up to 35,000 extra deaths this year may be caused by cancer as a result.  

Latest Government statistics show there are still about 37,000 Covid-19 patients in Britain’s hospitals, a figure which has remained unchanged since peaking at 39,000 on January 18.

There are almost 50 per cent more patients being treated for the disease now than at the peak in April, when inpatients peaked at 21,684. Back then, the NHS was almost entirely was shut down so medics could prioritise the virus. 

Hospitals are under even more pressure now as they try to juggle the devastating winter wave of Covid with other treatments and services. 

Demand for oxygen has surged five-fold in some NHS hospitals, a senior medic claimed today as trusts continue to grapple with the winter wave of coronavirus admissions

 

Professor Pearse told Sky News today: ‘We’re seeing a massive number of patients not just in intensive care, but also in general medical wards, who need oxygen.

‘We’re seeing five-fold increases in oxygen demand and in a lot of hospitals, and, unsurprisingly, that’s hard to deliver on occasions.’

Professor Pearse likened hospital oxygen delivery systems to a hot water system, adding: ‘If the pressure in your hot water system gets very low, it’s not that the water stops flowing completely.

‘It’s just that you’re not getting the pressure in the shower that you might like and that can cause technical problems around the place.

‘You might need to think about how can you avoid wasting water, or you might turn off some taps that you don’t need, or turn down when you don’t need much water.’

This combination of measures are being highlighted by ‘oxygen marshals’ who are educating other members of staff about how to be more ‘effective’ with the oxygen supply, Professor Pearse said.

NHS intensive care units are almost 70 per cent busier than they have been at any time over the past five years, MailOnline analysis of official figures shows.

Official statistics reveal 5,176 critical care beds were occupied on January 17, the most recent day statistics are available for. 

For comparison, there were 3,066 critically-ill patients at the same time last winter, and the average over the last four years stood at 3,200. 

Analysis of the most up-to-date NHS data also revealed a quarter of NHS hospital trusts — or 35 out of 132 — had no spare capacity in their intensive care units on January 17. Just 14 facilities were completely full on the same day last winter.  

The super-infectious Kent strain of Covid sparked a devastating winter wave of ICU admissions which have stretched NHS intensive care capacity to its limit, with hospitals having to open emergency beds and scrap thousands of operations to free up space for incoming virus patients. 

But in a glimmer of hope, Department of Health figures show daily Covid hospital admissions in England may have peaked. Rates dropped four per cent in the seven days to January 15, the latest date for which data is available — but are still higher than they were in the darkest days of the pandemic last spring. 

Dr Vin Diwakar, NHS England regional medical director for London, said the situation in hospitals, particularly in the capital, was ‘really precarious’.

‘In London, more than half of all patients in hospital are being treated for coronavirus and sadly over 1,000 patients died in hospital in London just last week, every single one a tragedy,’ he said.

‘Nationally, there are 34,000 people in hospital and pressure remains intense on our staff. We do have hope now with an increasing amount of people vaccinated but we must remain vigilant. Stay home, follow the guidance and help us to save lives.’ 

He added: ‘The problem really is that it is yet another problem we need to solve. It’s yet another thing that we need to keep an eye on and watch. It’s just another contributor to the cognitive load.

‘So for me, this isn’t so much about can patients get enough oxygen, it’s much more a signal, a marker that the NHS is still under immense pressure.

‘Even though we’ve seen a peak in infections, we’re still seeing very, very large numbers of patients in hospitals, 40,000 patients in hospital with Covid-19. Ten per cent of those in intensive care.

‘And that demand is going to carry on for some months. And we know it’s going to be a very, very hard year in 2021, we’ll still be looking after a lot of Covid patients in June.’

Meanwhile, there were 800 fewer cancer surgeries in the first two weeks of 2021 than normally take place during that period, according to provisional data.

The ‘weekly activity returns’ data, seen by the HSJ, showed that from November 1 to December 20, London performed a weekly average of 410 cancer surgeries. 

But in the fortnight between January 3 and January 17, the capital averaged just 270 cancer ops per week –  140 less, or 34 per cent.

Activity in Essex, Hertfordshire, Bedfordshire and Milton Keynes was down 34 per cent, the equivalent of about 155 operations.

In Sussex and Surrey it was 28 per cent lower than expected, more than 100 operations, and in Cambridgeshire and Norfolk the figure was down 23 per cent, equating to about 120 operations.

Professor Neil Mortensen, president of the Royal College of Surgeons in England, told the HSJ: ‘Surgeons in London told us just before Christmas that they were forced to cancel swathes of P2 [urgent] surgery, including cancer.

‘Not enough private sector capacity had been secured, and NHS hospitals were overwhelmed by steep increases in covid patients. We made urgent representations to NHS England, as this group of patients need surgery within 28 days, so cancellations and delays are hugely problematic.

‘Although deals have now been struck, and operations booked in again, we cannot continue with a stop-start approach to surgery. We’ve run the system too ‘hot’, pushing both physical resources and staff to their limits. Looking ahead, we need to build a more resilient and sustainable system.’

An NHS England spokeswoman said: ‘The most recent, complete data shows that cancer surgery in November was at 94 per cent of the level it was in 2019 and figures for after this point do not reflect the full picture of surgery that took place.

‘The NHS is facing unprecedented pressure which has meant some procedures have had to be delayed but, thanks to the hard work of NHS staff and hospitals working together, surgery levels in most areas remain above or close to pre-pandemic levels.’

Experts estimate there are 50,000 patients with undiagnosed cancer due to Covid-19 chaos in the NHS – a backlog which could take up to 18 months to tackle in England alone.

Damning figures from the first wave suggest that up to 35,000 extra deaths this year may be caused by cancer as a result of the pandemic.

At least three million people are waiting for screening while around 350,000 did not get the urgent referrals they needed in 2020.

It comes after health investigators launched a probe into the provision of piped oxygen gas supplies to hospitals.

The Healthcare Safety Investigation Branch (HSIB) launched the national investigation after a hospital trust declared a major incident when demands on its oxygen supply led to patients being diverted to different hospitals and a need to transfer patients between clinical environments.

The trust had sufficient supplies of liquid oxygen available but its piped oxygen system was unable to deliver the volume of oxygen gas required to meet all patient needs, the HSIB said.

The HSIB said there has been increased demand for oxygen during the pandemic. It warned that insufficient oxygen supply to seriously-ill patients can have very severe consequences, including death.

Meanwhile BOC, the main oxygen supplier to the NHS, said in a statement on its website that it has helped with 30 ‘system upgrades’ to increase the capabilities of oxygen delivery systems in hospitals across England, Wales, Northern Ireland and Ireland.

NHS Providers, which represents acute, ambulance, community and mental health services, called for NHS trusts to be awarded capital funding to address important maintenance work.

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