Doctors warn of anaesthetic drugs shortage

Resuming non-emergency operations hampered by lack of adequate supplies for intensive care units

MANY hospitals believe they are “nowhere near” returning to operating at full capacity for non-emergency patients because anaesthetic drugs remain low following the peak of the Covid-19 crisis.

A group of doctors, speaking to The Sunday Telegraph on condition of anonymity, added that some NHS trusts were also weeks away from getting infection control measures right to ensure normal surgeries can resume.

Several theatres in the south west are understood to have been particularly short of muscle relaxants and Propofol in recent weeks. Another doctor said the situation was “rapidly changing”, however.

The Telegraph first reported last month how Propofol, a commonly used anaesthetic, and Alfentanil, an opioid painkiller, had been running low due to the increased pressure on intensive care units.

“If anything the situation has got worse in our hospitals,” said one senior doctor. “We are nowhere near a return to full capacity, and many other hospitals are in a similar situation.”

The Royal College of Anaesthetists has developed a joint strategy document on “Restarting planned surgery in the context of the Covid-19 pandemic” in which it makes clear that planned surgery should not resume until “sufficient anaesthetic and critical care drug stocks have been secured”.

Prof Ravi Mahajan, president of the college, said on May 1 it “is clear that the NHS cannot simply resume planned surgery services before sufficient resources are in place”.

“As well as adequate PPE and drugs supplies, staff capacity will be key in resuming planned surgery, and I am conscious that anaesthetists and all healthcare staff have been working incredibly hard throughout the pandemic,” he added.

Letters were sent out the same week by the Government to hospitals urging them to make preparations to return to regular treatment. The request comes amid warnings that more than 2,000 cancer diagnoses a week were being missed as a result of Covid-19.

At the peak of the crisis over the Easter weekend, 40.9 per cent of acute beds were unoccupied – about four times the normal number. In the same week of 2019, 90 per cent of critical care beds were occupied.

Clinicians, meanwhile, are getting increasingly concerned at the potentially fatal consequences of the public being fearful of attending accident and emergency wards.

“Restarting normal activity is already a major challenge,” the group of doctors added. “In addition to anaesthetic shortages in theatre, everything has to be done in PPE, and the PPE stocks are critically low. So we’re not sure if we can start operating again at full capacity, or see patients in clinic at full capacity, because we don’t have the supply. People will die as a result of not coming in for their planned operations.”

On April 2, four leading royal colleges and health organisations asked staff to “act immediately” and use alternatives to some “first line” medications in new guidance on changes to specific anaesthetic drugs facing “pandemic pressures”. However, government sources said medicines shortages have been an issue for many years prior to the Covid crisis.

More than 100 medicines commonly used to treat patients have been banned from parallel export out of the UK to help uninterrupted supply of medicines to the NHS and patients.

A Department of Health and Social Care spokesman said: “We are aware there is an increase in demand for a number of intensive care drugs and we are working with the pharmaceutical industry to make additional supplies available.

NHS England sources said issues with anaesthetics were not being felt on a national scale.