Emergency tests ordered as NHS struggles to give patients oxygen

Engineers sent to hospitals to check supply can keep up with growing demand after critical incident

NHS chiefs have dispatched emergency engineers to test oxygen flow capacity in hospitals, amid fears that trusts cannot provide enough of the gas for patients.

The measures follow the declaration of a critical incident at Watford General Hospital on Saturday, when oxygen delivery nearly failed.

Last night, leading critical care doctors warned that NHS planners had been caught off guard by the higher than expected proportion of patients, who, like Boris Johnson, require oxygen to prevent their condition worsening, but are not ill enough to need a ventilator.

Many of these patients are treated on general wards, rather than in intensive care units, where the piping is often more rudimentary.

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, said patients might have to be transferred between hospitals so as not to exhaust supply. “No one could have predicted that this would have been such an issue,” she said.

“We believe that enough oxygen is getting to hospitals, but the problem we have now is getting it distributed within the hospital to the beds.

“We have to keep pressure at a safe level in the system.”

Increasing numbers are being put on continuous positive airway pressure

machines, which can demand 50 litres of oxygen per minute.

Dr Tom Lawton, a Bradford-based critical care consultant, said his hospital could provide 3,000 litres per minute. “If you’re using 50 litres per minute for each patient, then that’s suddenly only five on a ward and 60 in a hospital – and we need more than that,” he told the BBC.

“It’s not just us, it’s also hospitals around the country. They weren’t designed for this level of oxygen use.”

Dr Nick Scriven, president of the Society for Acute Medicine, said oxygen delivery issues were likely to be worse

‘It’s not just us. It’s hospitals around the country. They weren’t designed for this level of oxygen use’

in smaller hospitals and those built 10 or more years ago.

“If your pipework is smaller that can be an important factor,” he added. “Smaller, older hospitals in London could be vulnerable.”

On Saturday, Watford General Hospital issued a statement warning everyone other than pregnant women to stay away after the oxygen system came close to breaking down.

Most hospitals are supplied by a single large cylinder of extremely cold liquid oxygen, which must be converted into gas before entering the piping delivery system. Only a limited amount of liquid oxygen can be converted each minute, however.

Some patients requiring high volumes of oxygen support are treated in intensive care, while others remain on the general Covid-19 ward, with procedures differing by trust.