Record coronavirus cases put Bristol hospitals under increased pressure

Record numbers of coronavirus patients and a surge in emergency admissions are forcing health chiefs to cancel most planned operations at Bristol Royal Infirmary (BRI).

Bosses at University Hospitals Bristol and Weston NHS Trust, which runs the BRI, Children’s Hospital and Weston General, say “very significant pressure” is having a huge impact on elective surgery, with only urgent treatment, such as cancer, going ahead.

Chief executive Robert Woolley said the Bristol, North Somerset and South Gloucestershire (BNSSG) CCG area was “one of the worst affected areas in England” for Covid-19.

He told a trust board meeting on Friday, November 27: “We are under very significant pressure. We are in excess of the first wave, without doubt.

“We are coping and have seen a welcome reduction in the rate of community Covid infection in BNSSG in recent days but that of course takes time to play through in terms of the impact of hospital admissions and our bed occupancy.

“This morning we have 134 (coronavirus) patients in the trust, 127 of them confirmed Covid positive with another seven being managed as if they are Covid positive while we wait for results to come back.”

The NHS is witnessing significant increases in coronavirus patients. Photo: James Koch

Woolley said 103 were at Bristol and the rest in Weston, including 15 in intensive care units.

“So we have had to open up intensive care surge capacity,” he said. “We have had to reconfigure our hospitals to create cohorted wards for Covid-positive patients.

“That restricts our flexibility enormously in terms of being able to flow other patients, particularly emergency admissions which haven’t gone down in the way they did in the first lockdown.

“We are seeing a near-normal level of winter pressure on our A&E departments. We have very little in the way of lower priority elective care going on, particularly at the BRI.

“We are maintaining as much of the high-priority elective surgery, particular cancer surgery, as we can.

“We are using the independent sector, which is additional capacity for the NHS, as fully as possible. We are using the Nightingale Hospital Bristol for children’s day case and outpatient procedures and for ophthalmology diagnostics.

“So we are making every effort to make as much elective planned care as we can but it is true that we are seeing a higher proportion of cancellations of surgery than we would like, and that is just because of the pressure on our critical care facilities and ward beds.”

Hospitals are facing “a near-normal level of winter pressure”, as well as the pressures of Covid-19. Photo: Martin Booth

Woolley said there were “huge efforts” by the trust and partner organisations to cope with the crisis.

“There are in the order of 300 community beds that have been commissioned to help the discharge of patients out of acute hospitals in BNSSG, being managed by Sirona and our local authority partners in social care,” he said.

Woolley said other initiatives to cope with demand were in the pipeline, including giving some suitable patients “virtual ward care at home”, such as pulse oximetry where a small device is clipped to a finger to measure oxygen levels.

“That is a pilot being pushed nationally and we are gearing up to do that in BNSSG,” he said.

Woolley said the NHS 111 First programme would be rolled out in the region in December to “channel patients who may need emergency care to the right level of emergency care”.

“This may include attendance at an emergency department (ED) but more likely a booked slot in an ED or potentially through other routes like going to their pharmacy or their GP,” he said.

Woolley added that staff had been working “phenomenally hard to keep patients flowing through our very hard-pressed facilities”.

“We are supporting them in every possible way we can. It is very important the public sees how hard the NHS is working with the impact of this pandemic which isn’t going away any time soon.”

Adam Postans is a local democracy reporter for Bristol.

Main photo: Martin Booth

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