The faked crisis in the NHS which is justifying the new lockdown

According to a report in the Health Service Journal the NHS in London will be overwhelmed within 2 weeks at present rates of growth in Covid-19 cases. The best case figure for a shortage of general, acute and intensive care beds is 2000 by 19 January. In the worst case modelled scenario the shortfall is 4,400 [1]

In terms of critical care beds the projected shortfall is in the range 417 to 945. [1]

The Guardian reports on this report and, naturally enough, sensationalises it (they have, after all, to keep selling newspapers):

Hospitals in London could soon be overwhelmed by Covid-19 and left short of almost 5,500 beds they need to cope with the explosion in cases, NHS leaders have revealed.

[2]

The sensation seeking Guardian journalists appear to have got the nearly 5,500 figure by adding the worst case figure for general and acute to the worst case figure for critical care.

At any event there is a projected shortfall.

Is this data faked? No; of course not. It is a modelling exercise and no doubt true.

The ‘fakery’ – and really it is a fraud rather than a fake is how this situation has happened. Let’s follow the Guardian’s lead and take the very worst modelled scenario: a shortage of 5,500 beds.

This is more than 11 months after the WHO announced a global medical emergency. More than 9 months after the dead started piling up in the UK and even the government’s Chief Medical Officer and the government’s Chief Scientific Adviser had to pull their heads out of the sand and admit Britain was about to be engulfed by a pandemic of a serious disease.

In 9 months they cannot have created, say, capacity for an additional 10,000 beds (including a spread of general, acute and critical care) in London?

They built a ‘Nightingale hospital’ (I wonder if they paid a consultant to come up with the name) with a capacity, according to the Guardian, for 4000 critical care beds. [3]. Yes; that is right, critical care beds – the highest level. The NHS report on this facility talks about “thousands of beds”. [4] This was at the end of March and the building of the facility was a real feel-good story and got some good publicity for Ministers. The total cost for 7 similar facilities around the country was £220 million. [4] By the end of April it became apparent that this was (yet) another UK Covid-19 scandal. The London Nightingale hospital had only treated 40 people; apparently in all the joy of the Health Secretary spending £220 million it hadn’t actually occurred to anyone to produce a viable plan to staff the new facilities. [5] Yes; that is right. The Nightingale Hospitals built at a cost of £220 million are scarcely being used because there was no viable plan to staff them. This is like building a school but not having a plan to hire teachers. As of December 29 the London Nightingale hospital was not being used at all and has in fact been mothballed. [6] (Incidentally the typical salary for senior Management Committee Members at Public Health England appears to be well over £150,000.00). [7]

In the last few days a plan has emerged to use London’s Nightingale hospital to provide 300 recuperation beds for non-Covid-19 patients to free up space in hospitals. [8] This appears to confirm the Guardian story from April that the issue was a lack of critical care nurses. (The government at the time tried to claim that the reason for not using the Nightingale hospitals was lack of demand [9]; but if this was true then they would be ready to use now and there would not be a crisis in London. Another lie).

How can they not have solved this problem in 9 months? Let’s help them.

  1. How many nurses do you need? The ideal nursing ratio in critical care is one to one. [10] However; this can be dropped. Indeed in London hospitals in some cases it is currently at 1 nurse to 6 patients. [11] Remember [1] that the shortfall of critical care beds by 19 January is 945 in the worst case scenario modelled. Let’s plan to build a capacity of 10,000 beds – twice the current worst-case shortfall projection – with a spread of general, acute and critical care beds. Let’s make 2000 of those beds critical care. That means we need 333 critical care nurses. A normal ratio for general nursing appears to be in range 1:4 to 1:8 with 1:10 being considered acceptable as a temporary emergency measure. [11] Let’s say 1:8 and consider the case of a projected shortfall of 4,400 general and acute beds by 19 January in London. Again; lets provide much more cover than the current projected worst case shortfall: 8,000 general and acute beds. That means 1000 nurses. So; to provide twice as much capacity as is currently projected in the worst case model we will need 1,333 nurses of whom 333 must be capable of working in critical care.
  2. We will also need to build another 1.5 Nightingale hospitals in London to provide our 10,000 beds. This will not be a problem; the total cost for 7 Nightingale hospitals was £220 million and they were set up in a matter of days. It is not as if the government is short of a few hundred million. (They can spend more than £155 million on a contract for unusable face masks which was handled by a government adviser. [12]).
  3. Where will we get our 1,564 nurses from? Bear in mind that normal ratios allow for up to a 50/50 mix of Registered Nurses and unregistered (presumably auxiliary nurses). [11a] This figure is based on a report from one particular NHS hospital but there is no reason to think that it is far off the mark. To be a Healthcare assistant in the NHS you need on-the-job training and a Care Certificate. The latter takes 12 weeks to get. [13] This is admittedly a very basic role – but certainly people at this level could perform many of the functions necessary to care for people with Covid-19 (such as personal care, turning them over, monitoring machines). It cannot be impossible to train a few hundred people for this role in 8 months surely? Another source for our auxiliary nurses is the British Army. The British Army has 1,895 Combat Medical Technicians. [14]. A job description for a Combat Medical technician is available here: [15] This role covers the Care Certificate at Level 3. So – finding several hundred auxiliary nurses is not a problem. Or, should not have been. The problem is where to find, say, 833 (50% ratio assumption) nurses who can work at the level of a UK Registered Nurse. (That is 500 for work alongside auxiliary nurses on general wards and 333 for our 2000 critical care beds). I accept that this is a skilled role and not one for which people can be quickly trained – even in 8 months. So we need to think creatively. On the other hand; 833 is not a vast number (and remember we are providing capacity for twice the expected worst case shortfall). How about New Zealand? There are more than 58,000 enrolled nurses, registered nurses and nurse practitioners in New Zealand. [16] New Zealand has had less than 2,500 recorded cases of Covid-19. If we had asked them nicely (and paid handsome salaries) one imagines we could have borrowed some nurses from New Zealand. Other sources, (apart from other countries), might include: fast-tracking student nurses in the last year of study in the UK, using junior doctors as senior nurses, and using retired nurses (another Covid scandal: it turns out that plans to use retired health workers stumbled on surveillance paperwork issues [17]). It appears that, effectively managed, this source (retired nurses and doctors) could very easily have covered our staffing shortfall many times over! According to the Telegraph report one reason why only 5,000 out of 30,000 eligible volunteers have been used is because of a lack of Prevent Programme training. The absolute reality then is that there is no valid reason why Public Health England could not have provided a surge capacity of 10,000 beds (including a mix of general, acute and critical care) in London by now.

This is why we can say that the current much hyped crisis in London was not only totally avoidable but in reality has been deliberately and artificially created by managers at Public Health England many of whom consume individually over £150,000.00 of tax-payer salary (plus pension benefits) each year. This my friends is the truly evil world we live in.

Note; I have focussed on nursing staff in the above analysis because this is where the shortfall apparently was. But in terms of provision of doctors for our 10,000 extra beds the approach would be similar; find them from overseas, use British Army doctors and use retired personnel.

Addendum

I have asked NHS England for a specific figure on how many patients have been treated at London’s Nightingale hospital up to 31/12/20. I will update this space when I get an answer. (PHE directed me to NHS England).

Update 16-1-21

It is well-known that China has built a number of temporary field hospitals. I asked the Internet the question: have they been used? According to this article in US npr.org the answer is they have. The article relies on data from the Chinese state which is a weakness. If true though, the answer is they have been used. They are now building more to cope with a new outbreak and it seems unlikely they would be doing this unless they intended to use them. Assuming this information is accurate it does lead to the question – why can the UK not manage to set up and run field hospitals for Covid?

Notes

  1. https://www.hsj.co.uk/acute-care/exclusive-london-will-be-overwhelmed-by-covid-in-a-fortnight-says-leaked-nhs-england-briefing/7029264.article
  2. https://www.theguardian.com/world/2021/jan/07/dire-warning-that-london-hospitals-could-be-overwhelmed-by-covid
  3. https://www.theguardian.com/society/2020/mar/25/nhs-nightingale-video-shows-scale-of-london-coronavirus-hospital-excel
  4. https://www.england.nhs.uk/wp-content/uploads/2020/08/FOI_Costs_of_Nightingale_Hospitals.pdf
  5. https://www.theguardian.com/world/2020/apr/21/nurse-shortage-causes-nightingale-hospital-to-turn-away-patients
  6. https://www.dailymail.co.uk/news/article-9095087/Londons-Nightingale-hospital-quietly-broken-arent-medics.html
  7. https://newobs.files.wordpress.com/2020/08/phe_annual_report_2018_2019_print.pdf
  8. https://www.bmj.com/content/372/bmj.n15
  9. https://www.theguardian.com/world/2020/may/04/london-nhs-nightingale-hospital-placed-on-standby
  10. https://pubmed.ncbi.nlm.nih.gov/20500648/#:~:text=Background%3A%20Since%201967%20the%20gold,this%20standard%20has%20been%20challenged
  11. https://www.uhs.nhs.uk/Media/UHS-website-2019/Docs/About-the-trust/performance/TB-6-monthly-staffing-review-report.pdf / https://www.rcn.org.uk/professional-development/publications/pub-003860
  12. https://goodlawproject.org/update/ppe-masks-not-fit-for-purpose/
  13. https://www.healthcareers.nhs.uk/explore-roles/healthcare-support-worker/roles-healthcare-support-worker/healthcare-assistant / https://www.skillsforhealth.org.uk/images/projects/care_certificate/Care-Certificate-FAQ-for-Health-and-Adult-Social-Care-Nov-20.pdf
  14. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/777578/08152.pdf
  15. https://apply.army.mod.uk/roles/army-medical-service/combat-medical-technician
  16. https://www.health.govt.nz/news-media/media-releases/new-zealands-nursing-workforce-largest-its-ever-been
  17. https://www.telegraph.co.uk/news/2020/12/29/bureaucracy-stopping-retired-medics-returning-nhs-front-line/

Author: justinwyllie

EFL Teacher and Photographer