Cancer operations are being postponed at Birmingham’s hospitals as pressure mounts inside the city’s NHS, with one boss describing the current worrying situation as ‘a perfect storm’.
Rising Covid cases allied to people ‘flooding’ A&E departments has forced doctors to cancel ‘a small number’ of vital cancer ops over the last fortnight – with more likely to be lost in the coming weeks.
A lack of guaranteed intensive recovery beds is responsible for the ‘tragic’ delays, said Ian Sharp, deputy medical director at University Hospitals Birmingham.
READ MORE: Covid pressures, cancer delays and burnout – city NHS ‘dumbstruck and angry’ over freedom plan
He said: “In absolute terms the numbers affected are low but if you are one of those people that is a tragic circumstance to find yourself in.
“We don’t wish to cancel any operations, certainly not on the day of surgery or the day before, and especially not cancer operations, but the reality is that we have to sometimes reconsider cases that require ITU or a certain high level of post operative care.”
More high dependency care areas are now open at the Queen Elizabeth and Solihull hospitals but even with those the “sad reality is we are cancelling operations.”
“It has been worse in the last two weeks and the next few weeks are going to be difficult,” he said.
A number of cardiac patients waiting for vital treatment are also being sent out of the city to less busy trusts who can see them sooner, for the same reason.
Meanwhile, across at Birmingham’s Women’s and Children’s hospitals, chief executive Sarah-Jane Marsh has acknowledged we are now in ‘a third wave’ of coronavirus.
She tweeted: ‘No-one has the physical or mental resilience for this wave, but it’s here, and we must go again.’
Her tweet drew a flurry of messages from colleagues and others across the NHS locally.
Matt Boazman, her Trust’s chief officer for strategy, added: “Was not expecting to have to be running the incident room again so soon but we will go again, supported by our amazing staff and BWC spirit.”
Their angst mirrors the increasingly alarming calls from other medics across the city, reported by Birmingham Live with increasing intensity this past fortnight.
They want the Government to acknowledge the risks from plans to relax restrictions next week, fearful of the potential impact on already rising Covid rates combined with more hospitalisations among the unvaccinated.
However, as recently as yesterday (Friday) the region’s Conservative Mayor Andy Street said he did not expect the Government to back down on its ‘freedom day’ plans – while adding he hoped people would ‘exercise personal precautions’ and not treat it as a ‘free-for-all’.
He also added the numbers in hospitals with Covid now was ‘small’ compared to during the January surge, pre vaccine rollout.
But anxiety about what is coming in the next weeks extends across the NHS locally.
At Sandwell and West Birmingham Hospitals NHS trust, Dr Sarbjit Clare, acute medicine consultant and part of the leadership team, described the idea of loosening restrictions further as ‘deplorable’ and ‘reckless.’
Ambulance chiefs too have spoken out, worried that delays at the front door of A&Es across the patch offloading 999 patients is risking them not getting to other emergencies in time.
And GPs – bearing criticism over phone triaging systems and face to face access – warn they too are battling to cope with a 50% increase in contacts.
Dr Manir Aslam, GP in Ladywood, voiced his fears for his unvaccinated or part vaccinated patients in particular, warning now is not the time to let Covid ‘run rampant.’
They could not be doing more collectively to sound the alarm, their aim clearly to demonstrate to Government that its plans to introduce more freedoms on July 19 are unwise at best.
New data from Birmingham City Council has also now revealed a staggering number of adults have still to get their first jab, despite extensive efforts to open up access to everyone through mass vaccination initiatives, walk-in clinics and mobile vax vans.
Up to July 6, some 360,000 over 18s in the city had still not taken their first jab, and only two out of the city’s 69 ward areas have managed to get 70% of all adults fully vaccinated.
During a live Q&A with Birmingham Live yesterday, UHB leaders Mr Sharp, director of nursing Margaret Garbett and chief pharmacist Prof Inderjit Singh outlined how rising hospitalisations for Coronavirus are affecting other services – with A&E pressures, elective operations and major surgery all suffering already.
“We are working very hard to limit delays at the front door of our hospitals,” said Mr Sharp, a consultant specialising in oral and maxillofacial surgery.
“But the pressure at the front door – whether from people who should be able to access care elsewhere, or from Covid, or from other acute illnesses and conditions – is very high.”
These included people who were desperate for a face-to-face encounter with a medical professional, even if they did not require A&E services.
Mr Sharp said demand was currently ‘higher than a typical pre-Covid winter’ – and that was why plans to further extend restrictions just now, with so many still not fully vaccinated, are causing concern among medics.
“Personally I think it’s important that society is able to return to something that appears like normal and the people making these decisions have far more information at their fingertips than I do – but am I worried about the implications for us and the health system in general? Yes, I am.
“It feels like something of a perfect storm.
“I am worried for our staff and for the patients who will be unable to access the care they need because of the unrelenting pressure that we are seeing from Covid and emergency care.
“That is a very real problem and will get worse over the summer.”
The toll of 16 months of the virus on already understaffed departments, with significant numbers of staff sick or isolating, is also making things worse, he added.
“We had been understaffed for some time, and Covid stretched that shortage even harder and even further,” he said.
“We have all seen the stories of heroism in the NHS but the reality is that healthcare workers do their jobs because it makes a difference for people, and much of what we do is based around their extra goodwill.
“The prospect of being able to do that again (call on their goodwill again) when they are already exhausted, and would like a break through the summer too, is hard.”
He illustrated the impact of Coronavirus on the hospitals, where around 2,400 bed spaces are spread across four hospitals – the QE, Heartlands, Good Hope and Solihull.
One hundred Covid patients in hospital today equals around 4% of beds – but many are in beds that are normally taken up by elective care patients, he explained.
The prospect of more beds for Covid patients in the coming weeks means “the amount left is constrained” – and that means “fewer elective operations can be planned in, especially those needing intensive care afterwards.”
The Trust’s director of nursing Margaret Garbett added: “We are seeing an increase in our Covid patients, with 100 inpatients and 20 in intensive care. The number sounds small but the impact on other services is increasing.
“All our hospitals are very full.”
A&Es are very busy, with around 1,300 new patients a day, which was typical of a pre-Covid winter, she added.
How the mood of the NHS locally is playing out on social media
Dr Marie Kershaw, clinical psychologist and consultant in Birmingham, responding to Sarah-Jane Marsh’s tweet, wrote: “Thinking of you all. It is just relentless. Similar in children’s social care. Knock on impact of increased stress in families is hitting and referrals rising. Our social workers and colleagues are tired. We keep on keeping on, but it’s hard work digging deep for so long.”
BirminghamLive is supporting the vaccination rollout – vaccines have been vigorously tested and are recognised as the only way to protect our region from Covid-19 and get all our businesses open again safely.
But you may have questions still. You can ask your doctor and also dedicated websites have been set up by Birmingham and Solihull Clinical Commissioning Group and its partner CCG in Black Country and West Birmingham with everything you might want to ask about the local vaccination rollout.
If you want to book a vaccine appointment, visit the NHS vaccines website here.
We hope these other useful links will help you make health decisions for you and your family.
For Cath Berry the fear is personal. She responded: “Despair, I spent three weeks on a ventilator with Covid in December . Someone working with a family member tested positive this week . I am trying not to worry – I can’t go through that again.”
Dr David Nicholl, a consultant neurologist in the city, tweeted it was ‘utterly insane’ to extend freedoms while vaccinations are not yet at the level they need to be and with rising cases.
Another tweet added: “So very worrying to read this. I’ve been telling anyone who will listen, we are not through this yet. Infection rates so high sadly, eventually equates to patients in beds…yet so called “freedom day” is upon us… freedom for whom?”
Meanwhile, GPs, public health officials and councils are using their platforms to send a single clear message to everyone who will listen: get vaccinated.
A DHSC spokesperson, asked about concerns from the NHS here over the timing of impending new freedoms, said:
“The success of the vaccine rollout is saving lives, having severely weakened the link between cases and hospitalisations.
“We have taken a cautious approach to proceeding with the roadmap, delaying step 4 to allow for millions more vaccinations so every person most at risk is fully protected.
“Our approach after step 4 balances the need to protect both lives and livelihoods and we will only proceed on 19 July with our four tests having been met.”
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