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‘Perfect storm’ of more Covid, soaring A&E demand and staff exhaustion feared by London hospital chief

·3-min read
St Mary's Hospital Paddington, London (NIGEL HOWARD)
St Mary's Hospital Paddington, London (NIGEL HOWARD)

Hospitals will be unable to reduce the backlog of patients awaiting care or increase access to visitors if they are hit by a “perfect storm” of rising Covid and staff burn-out, a London NHS chief has warned.

Professor Tim Orchard, chief executive of Imperial College Healthcare NHS Trust, said its hospitals - which include St Mary’s and Charing Cross - and others in the capital were struggling with A&E numbers normally only seen in the winter.

At the end of July, Imperial had 1,464 patients waiting more than a year for non-emergency treatment or surgery. Pre-pandemic, it had fewer than 10. Across London, more than 800,000 patients are awaiting hospital treatment.

Professor Orchard said staff were exhausted and some hospital services would have to be postponed to help them cope in the event of more Covid cases.

“If all of this comes together in a perfect storm, we are not going to be able to continue with our elective programme in way we would like to do,” he said. “We have to be aware of that.

“It’s a concern, given usage of urgent and emergency care pathways. Like most other trusts in London, we have seen a significant increase in the number of people arriving in the emergency department.

“What we are trying to do is manage this urgent and emergency care demand and try to ensure we are getting on top of the backlog.”

Imperial’s hospitals already limit patients to one visitor for only an hour a day. Professor Orchard said the restrictions would have to remain in force this winter to prevent the spread of infection.

The throughput of A&E patients continues to be hindered by the need to separate Covid-positive cases at the front door and treat them in isolation. Professor Orchard said some people seeking help in A&E “probably don’t need to be in ED [the emergency department]”.

St Mary’s hospital, Paddington (Imperial College Healthcare NHS Trust)
St Mary’s hospital, Paddington (Imperial College Healthcare NHS Trust)

Imperial today announced that its plans to redevelop St Mary’s, in Paddington, had taken a significant step forward with the submission of a full strategic outline case to the Government.

The plan is one of 40 new hospitals promised nationally by 2030. Imperial bosses fear that parts of St Mary’s may deteriorate beyond repair in six to seven years and hope to start part of the redevelopment before 2030, if funding can be secured.

The plan confirms Paddington as the “only viable location” for the redevelopment of St Mary’s. The new hospital would have 840 beds, probably across three main buildings, and cost £1.2 to 1.7 billion net, once receipts from the sale of surplus land are taken into account.

Professor Orchard said: “The trust has the biggest backlog maintenance liability of any NHS organisation and, as our staff and patients are very aware, the state of our facilities, with many pre-dating the NHS itself, makes it increasingly difficult to provide high quality care.

“We believe we have made the strongest of cases for redeveloping St Mary’s hospital to ensure we can continue our legacy of research, innovation, safe and high-quality care.”

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