Intensive care medics to care for more patients as the ‘only option’ in tackling Covid-19

Intensive care doctors and nurses are being told to care for more patients than normal as hospitals experience a surge in Covid-19 cases.

More general doctors and nurses and those who are less experienced will help support the most senior medics as they care for those who are seriously ill with coronavirus, according the Health Service Journal (HSJ).

Nicki Credland, chairwoman of the British Association of Critical Care Nurses, confirmed that the plans have been agreed across England and it is “the only option” available.

It comes as London in particular is experiencing a high number of cases.

The HSJ said it understands that acute trusts in London have been told to base their staffing models for intensive care on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants.

Normally, intensive care units work under Care Quality Commission (CQC) guidelines of one registered nurse to one patient.

The HSJ also reported that NHS trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle-grade doctors.

The normal guidance is that the consultant-to-patient ratio “should not exceed a range between 1.8-1.15”.

Nicki Credland, chairwoman of the British Association of Critical Care Nurses, said the plans have been agreed nationally.

She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available.

“We simply don’t have the capacity to increase our staffing levels quickly enough.

“It will dilute the standard of care but that’s absolutely better than not having enough critical care staff.

“There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.”

Alison Pittard, dean of the Faculty of Intensive Care Medicine, said the changes are the “only safe way to do it”.

She added: “I welcome the guidance that’s been agreed that will allow healthcare professionals to continue to deliver high-quality care in the safest possible way.”

NHS England and NHS Improvement told HSJ in a statement: “NHS staff are working round the clock gearing up to deal with this unprecedented global health threat and, as the professional bodies have said, doctors, nurses and other health professionals will rightly respond flexibly and compassionately.

“In the meantime, the public absolutely must play now their part by staying at home to stop the spread of this virus and save lives.”

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