Trusts to stop routine Covid tests for new patients amid ‘brutal’ NHS pressure

Overstretched hospitals are halting routine Covid tests for new patients as “brutal” pressures grow on doctors and nurses, independent Understood.

On Monday, there were 1,702 new hospital admissions of Covid in England as of 9 April – with 16,442 positive patients in a family – NHS leaders warned that their ability to tackle the backlog in planned care was at risk.

Despite pleas by NHS chiefs for measures such as wearing masks again to be put into effect, ministers said there were no plans to change the guidance.

independent He understands that at least two major hospitals, in Newcastle and York, have abandoned testing all asymptomatic patients in order to relieve pressure on beds – raising fears of Covid-19 spreading in unsupervised wards. Sources say other hospitals are likely to do the same as bed pressure worsens.

The sources said independent Some funds have started dropping only “red” Covid wards, while some are considering not separating patients at A&E.

The emergency pressure on NHS hospitals has gradually worsened in recent weeks with regions reporting serious incidents of bed shortages and a “perfect storm” by accepting Covid combined with staff absences.

Healthcare leaders have called on the government to introduce new measures such as the wearing of masks and restrictions on indoor mixing to help protect the NHS from “brutal” pressures.

One expert, critical care physician Tom Lawton, who analyzes hospital-acquired infection data, said stopping testing of patients in hospitals was “disturbing” and that the NHS would set “lights on” just as hospital infections were “as high as” it had ever been. . “

However, many hospital leaders said that not having beds to treat patients was the biggest risk. Glenn Burley, the NHS chief at hospital infection controls who warned it was “creating more safety issues than benefits.”

last week independent It revealed that patients waiting more than 12 hours to arrive at A&E averaged 1,721 per day, while ambulances took four hours to reach stroke patients and suspects.

The NHS, which represents hospitals in England, accused the government on Monday of abandoning any interest in Covid and “eliminating responsibility”.

Asked about the possibility of a return of Covid restrictions, a No 10 spokesperson said there was no change to the current guidance but that it would monitor the behavior of the virus through an ONS survey.

Dr Lawton said the decision to stop testing was “disturbing” and that the “flashing” mode was not a justified response to the problem.

He explained: “We don’t know exactly how severe hospital-acquired Covid is, but people die from it, and we know from studies like CovidSurg that Covid adds risks to surgery patients in the form of clots and heart attacks.

If we don’t have the resources to properly control infections, we should at least do what we can, such as keeping Covid patients and non-Covid patients as far away as possible. Stopping testing means we can do nothing to reduce the risk.”

He noted that hospital-acquired Covid risks are “as high as ever”. In the 28 days to 3 April, there were 11,936 probable or confirmed cases in England, which represented 23 per cent of hospital cases in total.

However, Dr. Chris Green, associate clinical professor and consultant physician in infectious diseases, cautioned that “getting this right isn’t going to be easy.”

He said a positive test does not determine when someone is contagious, so the safest measure is to isolate all patients who test positive, but that this puts a “significant additional burden” on hospital resources when they are already limited.

“We really need patients under the right specialist supervision at the right time, and anything that disrupts hospital efficiency risks increasing the indirect burden or impact from Covid,” he said.

“It will always be a difficult balance: protecting patients from hospital-acquired infections while at the same time making our resources go as far as possible for the many people who need it most. [treatment]. ”

Internal infection control guidelines for Newcastle Hospitals, which I have seen independentShow confidence no longer tests asymptomatic patients on entry.

Patients who need to be discharged to the nursing home will be tested within 48 hours of discharge – prior to these tests it was necessary prior to discharge.

An NHS source in Newcastle explained: “We’ve had major problems with occasional cases in routine inpatient testing, [which] I started closing a large number of beds, so a decision was made to only test asymptomatic and elective emergencies.”

“Things are really a mess right now. It’s a real challenge not having good evidence-based answers. It seems like the right thing to do, but we wouldn’t do it if we had any flexibility left in the family or staff.”

“Occidental Covid patients are less contagious, so the logic is that not knowing about them keeps the family open, and the overall risk to everyone is lower. They said you can’t cure anything if you don’t have a family.

Internal staff guidance at Newcastle also says that staff caring for patients on a ‘standard’ route do not need to wear personal protective equipment for aerosol generation procedures.

York hospitals have also moved to the same measures, and both institutions have dropped Covid testing for patients on the three, five and seven days of their admission.

A senior leader in the North East suggested Yorkshire’s move to forego patient testing was “unsafe” as there were hundreds of Covid patients in the family.

According to an analysis by Dr. Lawton, York Foundation and Scarborough Teaching Hospitals have one of the worst rates of hospital-acquired Covid infections.

Official NHS guidelines, published on April 5, said all asymptomatic and asymptomatic patients who need emergency or unplanned admission should be offered a PCR test. This may be a rapid PCR test.

She added that lateral flow devices can be used in emergency departments as a means of early detection.

Saffron Cordery, executive vice president of NHS Providers, said in a statement to independent: “NHS confidence across England remains under tremendous pressure as the number of people with Covid in hospital continues to rise.

The NHS still needs adequate infection control measures, to separate Covid patients from Covid patients [and] To do everything possible to reduce hospital-acquired infection rates.

“Reducing the trust’s infection control measures can greatly help in dealing with increased pressures as they deal with the current backlog of care as well as increasing demands, but given the ongoing risks from Covid-19 and the need to protect patients, staff and visitors, trusts must strike a balance Flour “.

The Yorkshire Hospitals Education Trust said it had “endorsed a risk-based approach to the ‘Live with Covid’ trust guidelines, in collaboration with the regional infection prevention team at NHS England and NHS Improvement. This is in response to the current critical situation, and will be reviewed on a regular basis and de-escalation as required.” “.

A Newcastle spokesperson upon Tyne Foundation Trust said: “Keeping our patients and staff safe is our number one priority. Any changes to patient pathways and Covid testing take into account national guidelines and our comprehensive internal risk assessments.”

Our IPC Guidelines are reviewed regularly, and changes are made as necessary. “We have had low-level hospital-acquired infections throughout the pandemic,” they added.