IntenseDebate - mvarrier

3 years ago @ http://www.conservativ... - David Davis: We are on... · 0 replies · +1 points

You mean like the Cygnus Exercise conducted in 2016. The report from which the government has refused to publish (because they didn't implement the recommendations...)

3 years ago @ http://www.conservativ... - David Davis: We are on... · 0 replies · +1 points

I think it would be feasible to use Nightingale style facilities to look after those patients who due to their frailty and co-morbidities are not suitable for critical care.
The problem in the first surge was that in my hospital at one point we had 40 ventilated patients. We usually have 12 ventilated ITU beds. We were using almost all the anaesthetic machines and surgical theatres as makeshift space. Nothing else can function effectively in these circumstances.
And whilst true that only 10% need critical care, the ones that don't tend to come in and then die or go home. The critically ill can spend weeks in ITU so they accumulate and accumulate...

3 years ago @ http://www.conservativ... - David Davis: We are on... · 1 reply · +1 points

Having cared for >100 intensive care patients with covid I can assure you it is slightly more complicated than 'lung issues'. But sounds like you're the expert so please tell us more.

3 years ago @ http://www.conservativ... - David Davis: We are on... · 0 replies · +1 points

PHE has also been subject to massive budget cuts in recent years (but as its funding is no longer part of the NHS budget it didn't flag up as a cut to the health budget...)

3 years ago @ http://www.conservativ... - David Davis: We are on... · 3 replies · +1 points

In a disaster or a war no-one is going to have a hip replacement, hernia repair, investigations for their back pain etc. We have been through a period where lots of operational elements of the NHS have been shut down and people are understandably upset by this.

3 years ago @ http://www.conservativ... - David Davis: We are on... · 4 replies · +1 points

The Nightingale hospitals do not work effectively as intensive care units. Critically ill covid patients are extremely complex with multi-organ failure and an unpredictable clinical course. They need the full resources (specialist teams/investigations/blood bank/pharmacy etc) available at a proper hospital otherwise they may die needlessly in the EXCEL centre.
The issue of staffing is also important. They need intensivists, anaesthetists, critical care nurses and skilled junior doctors etc. These people are in short supply all the time and there are barely enough to staff usual winter capacity.
A lot of credit in the first wave needs to go to the anaesthetists who worked with mutliple consultants and juniors resident day and night to keep the expanded critical care capacity operational. This was only possible by cancelling non-urgent surgery. Also the critical care nurses who juggled many more patients each than was safe.
I am open to suggestion as to the best way forward as a country but we simply do not have the staff to run critical care through the winter with a significant covid burden + the usual medical patients + elective surgery whilst treating all those likely to benefit from critical care.

4 years ago @ http://www.conservativ... - "Without drastic actio... · 0 replies · +1 points

Welcome. Thanks for engaging.

4 years ago @ http://www.conservativ... - "Without drastic actio... · 0 replies · +1 points

There are 7 trusts in our network. So yes, 68 in the other 6 (larger trusts)

4 years ago @ http://www.conservativ... - "Without drastic actio... · 0 replies · +1 points

That is incorrect. There are 5 in my itu alone (I am an Itu consultant)

4 years ago @ http://www.conservativ... - "Without drastic actio... · 0 replies · +1 points

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