NHS England cancels all non-urgent surgeries to free up 30,000 beds for coronavirus patients

All non-urgent surgeries will be suspended in England to free up 30,000 beds for coronavirus patients, the NHS has said.

From April 15, elective operations will be postponed, chief executive Sir Simon Stevens told the Commons Health and Social Care Committee on Tuesday.

The emergency policy will be in place for at least three months, he said.

“In readiness for the likely influx of more coronavirus patients, we are going to be taking concerted action across the NHS … up to a third of the general and acute beds – perhaps 30,000 of those general and acute beds – for coronavirus patients,” Sir Simon said.

He added that the NHS is also working intensively with community health services and social care to “unblock” the discharge process to help free up space.

Sir Simon was repeatedly challenged by the Committee over whether there were enough intensive care beds to cope with the global health pandemic which has infected a confirmed 1,950 in the UK.

Asked by Health Select Committee chairman Jeremy Hunt whether he was confident that there would be enough capacity, Sir Simon said: “This is, obviously, an unprecedented global health threat.

“Unmitigated, there is no health service in the world that would be able to cope if this virus let rip and therefore it is crucially important that the measures that were set out by Public Health England and the Government yesterday take effect in order to reduce the infection rate, such that the peak pressure on the NHS is moderated.

“In the meantime, what the NHS is doing is pulling out all the stops to make sure we have got as many staff and beds and other facilities available, including critical care, for that peak demand.”.

Sir Simon said production of protective equipment for medical staff treating coronavirus patients will need to “ramp up”.

He said that currently there were sufficient supplies for the “coming weeks”, although he acknowledged there had been “distributional problems” getting it to some parts of the country. However, he told the committee that more equipment would be needed as the outbreak progressed.

“We are going to need to ramp up production for gowns in particular, some of the face masks,” he said.

“Given that this is not a flash in the pan – this is not something that is going to be resolved in a fortnight or a month, the coronavirus pandemic is going to be with us for months to come – we are going to have to ramp up domestic production on those items as well.”

Sir Simon said there were a total of 6,699 adult mechanical ventilators in the NHS, as well as further 750 paediatric mechanical ventilators which can be re-purposed.

There are also an estimated 691 in the private sector and 35 in the Ministry of Defence, bringing the total to 8,175, he said.

He added: “For some weeks now we have been out preparing and procuring our mechanical ventilators, and can see a line of sight over the next several weeks to another 3,799.

Sir Simon Stevens said he wanted NHS staff to be confident they had the kit they need in response to concerns about the availability of personal protective equipment in hospitals.

“We all believe that staff do have a right to expect the sort of protection that would give them confidence, so part of the question, the dialogue with PHE, is ‘what is reasonable’ in A&E departments and other parts of the hospital,” he said.

Sir Simon added that the NHS had more than 28 million of the “most intense” kind of face masks, with more in production.

“Those face masks are here in the country,” he said.

Jeremy Hunt asked whether the “absolutely heartbreaking” scenes from northern Italy, with doctors forced to choose which patients get an intensive care bed, would happen in England and whether there would be guidance for medics.

NHS national medical director Stephen Powis said the health service and government were doing “everything we possibly can not to get into that circumstance”.

“Doctors make clinical decisions with patients, with relatives, every day and what we want to be able to do is to support doctors to make those continued decisions on the basis that they are currently making them.

“Because we are ahead of Italy in terms of the curve of the epidemic … that gives us the opportunity to do that planning ahead.”

The news comes as The Department of Health and Social Care said there are 1,950 positive confirmed cases in the UK and Dr Frank Atherton, chief medical officer for Wales, said a second person, a 96-year-old with underlying health conditions, has died from the strain in Swansea.

However the Government’s chief scientific adviser, Sir Patrick Vallance, said around  55,000 people in the UK probably have coronavirus and the aim is for fewer than 20,000 people to die from it.

In a letter to senior managers and hospital trusts, NHS chief executive Sir Simon Stevens and NHS chief operating officer Amanda Pritchard said the health service will “come under intense pressure” when the virus peaks.

It said important measures are needed to “free up the maximum possible inpatient and critical care capacity; prepare for, and respond to, the anticipated large numbers of Covid-19 patients who will need respiratory support; and support staff, and maximise their availability”.

However the letter said emergency admissions, cancer treatment and other clinically urgent care should continue unaffected.

Hospitals should also “urgently discharge all hospital inpatients who are medically fit to leave”.

“Community health providers must take immediate full responsibility for urgent discharge of all eligible patients identified by acute providers on a discharge list,” it read.

The document says the NHS is in the process of “block-buying” capacity in private hospitals, which should be completed within a fortnight.

“Their staff and facilities will then be flexibly available to you for urgent surgery, as well as for repurposing their beds, operating theatres and recovery facilities to provide respiratory support for Covid-19 patients.”

Community health providers and social care providers are also being asked to free up beds that could be used flexibly, the letter went on.

It added: “Emerging international and UK data on Covid-19 patients suggests that a significant proportion who are hospitalised require respiratory support, particularly mechanical ventilation and to a lesser extent non-invasive ventilation.

“Work is well in hand nationally to secure a step change in oxygen supply and distribution to hospitals.”

More staff will be needed to support patients with respiratory needs and “refresher training for all clinical and patient-facing staff must therefore be provided within the next fortnight”.

The NHS will also test any staff with symptoms who would otherwise need to self-isolate for seven days and pregnant workers or others at increased risk may need to work remotely or move to a lower risk area, the letter said.

The Prime Minister is chairing daily Cobra meetings has urged Brits to stay at home for 14 days if they or anyone in their household has a cough or temperature.

Boris Johnson has also asked the nation to not take part in mass gatherings and go to pubs, bars and theatres  in a bid to control the strain.