‘Not enough beds’ in intensive care
CRITICALLY ill or injured patients are being turned away from their local hospitals because their intensive care units (ICU) do not have enough beds, doctors have warned.
The problem is the most severe in Wales, according to a new UK-wide survey of ICU consultants who claim bed capacity in these units can reach between 95% and 100%.
In some cases, patients who need potentially life-saving treatment need to be temporarily moved from intensive care to other wards – and are even sent to hospitals in neighbouring health boards.
The highest level recommended for safe and efficient patient care in ICU is 85%, but many Welsh hospitals regularly fail to meet this target.
Accident and emergency staff at the University Hospital of Wales, Cardiff, have been experiencing exceptional demand in February and into March.
Cardiff and Vale University Health Board’s medical director Dr Graham Shortland said ICU patients sometimes need to be “repatriated” for their own safety.
“We have seen, compared to February 2017, a 7% increase in attendances for the emergency unit,” he said.
“More specifically the increase relates to severely ill patients and we have seen an increase of 13% in patients requiring resuscitation.
“Also of those patients who are severely ill there has been a 15% increase in patients attending over the age of 85. These patients may be very unwell and require specialist care.”
He said when a hospital is at its highest level of pressure, known as escalation level four, Welsh health boards turn to the Critical Care Network for support.
“It is important to note we are a tertiary centre and we regularly work with neighbouring health boards to routinely repatriate patients back to their local hospital when their episode of tertiary care has been completed,” he added.
“This is in the best interest of the patients and families concerned. When this is not possible we will also follow our own internal escalation processes.”
Testimonies from doctors in the survey, conducted by the Faculty of Intensive Care Medicine (FICM), revealed that intensive care units are struggling to cope with the numbers of patients needing potentially emergency care, such as after a car crash, heart attack, stroke or cancer operation.
According to their survey, which was completed by 20% of intensive care medicine (ICM) consultants across the UK, three out of five units (62%) do not have a full complement of critical care nursing staff.
They claim this regularly leads to cancelled operations and a greater risk of patient safety being compromised.
Dr Carl Waldmann, Dean of the Faculty of Intensive Care Medicine, said each UK health board and trust needs to make the modelling of critical care need and resources an “urgent priority”.
He said: “While I am very concerned with some of the results of this survey, unfortunately none will come as a surprise to the healthcare professionals who manage these challenges on a day-to-day basis.”
Responding to the survey, a Welsh Government spokeswoman said:
“We take any concerns on critical care pressures very seriously. We’ve made clear to health boards our expectations for collaboration and planning on a regional basis to meet rising demands and improve services.
“The critically ill implementation group will shortly publish a critical care capacity and workforce plan, and we will work with the group and health boards to consider how to best address its recommendations.”