NHS in crisis in Milton Keynes as highest possible emergency state is declared at our hospital

Milton Keynes hospital is running at OPEL Level 4, the highest emergency level, it has been revealed.

Health chiefs are struggling to cope with more Covid patients than they had at the peak of the pandemic in Spring 2020, and at the same time ambulances are under huge strain.

In order to cope, patients may have to be discharged earlier than usual, and care services could have to be reduced, say, health bosses.

But NHS East of England has given assurances that emergency and urgent care will continue unaffected.

According to NHS England protocol, OPEL 4 means: ‘Pressure in the local health and social care system continues to escalate, leaving organisations unable to deliver comprehensive care. There is increased potential for patient care and safety to be compromised."

Under this level, “decisive action must be taken by the local A&E Delivery Board to recover capacity and ensure patient safety” the guidelines state.

Yesterday (Thursday) Ann Radmore, NHS regional Director for East of England, wrote to officials in MK and elsewhere in the region informing them of the general emergency state of the NHS nationally and locally.

Her letter, leaked to the Citizen, states: “As you are aware, the NHS in England continues to operate in a Level 4 major incident, reflecting the significant clinical and operational challenges faced by the service in managing Covid and the impact of this on urgent and routine services. We are currently experiencing a significant increase in Covid.”

Throughout the East region, the number of acute inpatients with Covid has increased from 935 to 1729.

"This figure is still growing and is greater than the number of cases at the peak of wave one in Spring 2020,” the letter states.

Staff sickness is greatly adding to the problem. Thousands are absent across the region and “significant numbers” of acute beds are having to be closed.

"It is our understanding that over 1600 care homes beds are closed across the region for a range of reasons, with Covid and workforce availability being the most significant,” wrote Ms Radmore.

Meanwhile the ambulance service is also stretched to the limit, with ambulance handover delays of more than an hour averaging 200 per day across the East region.

“EEAST, our main ambulance service, is consistently on Resource Escalation Action Plan (Reap) 4 Surge 4, the highest level of escalation for ambulance services,” the letter states.

"This means that 200 critical patients are being delayed in receiving treatment within a hospital for more than an hour and in a significant number of cases for many hours. In addition, there are significant delays to our most critical response times for patients needing ambulance support,” it adds.

Now, all local NHS services have been requested to take extreme measures to cope during the crisis.

"Recognising the seriousness of the challenges we face, and the need to respond in accordance with the Level 4 incident, we have asked all NHS services to take additional steps to seek to safeguard the safety of patients in immediate need of support and under the Civil Contingencies Act, to work with other Cat 1 responders to support the health and social care system across the East of England,” Ms Radmore states.

The key, she said, is to consider discharging patients if possible if they no longer require acute medical support.

"We are writing to ask you, reflecting that we are in a level 4 major incident and is subject to a further escalation in pressure, consider what more you can do to support the NHS at this time,” states the letter.

This may require providers to reduce their packages of care and services in order that they can support a greater number of people, it suggests.

“Support for seven-day discharge and consideration of flexibility in IPC practices at a local level would be further examples of support that could be of benefit to our patients. We will be constantly reviewing the arrangements we have in place and will seek to keep you informed of any changes in our approach,” wrote Ms Radmore.

Currently, as a priority, the NHS is concentrating improving the accessibility of emergency services through the Easter period, traditionally a busy time even without Covid.

Government figures for the past seven days show there are 139 patients with Covid in MK hospital. Over past week, nine deaths have been recorded in MK of people who died within 28 days of a Covid positive test.

The number of positive tests recorded from the borough over the past seven days is 1,482. But many people are failing to record their tests since charges were imposed for lateral flow kits.

A spokesperson for NHS East of England told the Citizen today: “High Covid infections continue to put considerable pressure on healthcare capacity and ambulance services across the region.

“For a short period of time some routine services may be postponed or take a little longer than usual while we prioritise patients in the most immediate need. In those cases, services will discuss this directly with the patients affected.”

“All emergency care will continue and anyone in a life-threatening situation should always call 999. All urgent care services including cancer care, will also continue unaffected. Please continue to access NHS services in the usual way as needed through GPs, pharmacies and NHS 111 online and by phone.

"We also urge everyone to take up the offer of life-saving Covid vaccinations.”