Greater Manchester hospitals start cancelling operations as patient numbers near April peak
Exclusive: As pressure grows, Wigan’s NHS trust has suspended non-emergency operations, while Stockport has also cancelled some procedures until the weekend. Jen Williams reports.
Wigan and Stockport have become the first hospital systems in Greater Manchester to suspend operations, even before October ends – as the number of Covid patients across the conurbation nears April’s peak.
Two separate sets of data leaked to the M.E.N. show how demand for space in hospitals here is growing rapidly at the same time as the system tries to continue with normal operations, treatments and procedures.
Yesterday there were 953 confirmed Covid patients across the whole system, according to an internal dashboard circulated among senior figures.
Separate leaked data shows there were 1,051 Covid patients when each hospital was at its busiest in April.
That second set of data – covering the whole of the North West – reveals the number of Covid patients outside ICU at Wrightington, Wigan and Leigh NHS Trust was, on Sunday, at 97pc of its peak on April 30.
The trust has now halted non-emergency procedures and escalated its official alert level.
It is understood the bulk of those patients are aged 61-85 years old, although there are also substantial numbers of people in their 40s and 50s being admitted and staying in hospital for some time.
That, in turn, is putting pressure on the entire hospital system.
Meanwhile Stockport NHS Foundation Trust is cancelling its more routine electives until the weekend for the same reason, although major planned surgery will still go ahead.
Unlike the first phase of the pandemic, hospitals have been told to continue all of their normal activity as they head into winter, amid fears that too many people missed treatment – in some cases life-saving treatment – due to cancellations earlier in the pandemic.
However trusts are coming under significant pressure as they try to balance rising numbers of Covid patients with normal procedures, with medics reporting huge demand in A&E and difficulty in transferring them through into beds.
The North West data leaked to the Manchester Evening News , covering each trust in the region, shows the number of Covid patients in general and acute beds – in other words outside ICU – in Greater Manchester is creeping up towards those seen at their busiest point in April, at the same time as hospitals try to continue with ‘business as usual’.
Liverpool University Hospitals NHS Foundation Trust and Blackpool Teaching Hospitals NHS Trust have already exceeded their April peak numbers, with Wigan on 97pc on Sunday, Pennine Acute on 89pc, Stockport on 71pc, Tameside and Glossop on 66pc and Salford on 56pc.
Bolton has 40pc of the non-ICU Covid patients it saw at the peak in April and it is understood its NHS trust has now opened four separate wards to treat them. Like Wigan, it is seeing a significant rise in middle-aged Covid patients.
The cancellations in Wigan and Stockport, even before winter kicks in, are therefore further concentrating minds within the system here.
“When people say the NHS will be able to ‘cope’ what do you mean?” said one senior politician.
“Are we talking about its ability to cope with Covid? Or are we talking about its ability to cope to do all other the stuff the NHS is meant to do?
“It’s a conflation of the year-round crisis in the NHS with Covid. So in some ways Wigan is a bit of a worry for the rest of Greater Manchester.”
It is unclear precisely why Wigan has been hit earliest, although some senior figures point out that its infection rate patterns over the summer were more like Liverpool’s than the rest of Greater Manchester.
While community transmission in other boroughs here had been widespread – and in some respects never went away – after the first peak, in Wigan, as in Liverpool, it remained comparatively low until the summer ended.
Since then cases in both areas have rocketed, as have hospital pressures.
One senior figure said there has been a marked trend of cases among those in middle age, even if the bulk are still accounted for by those over 60.
“It’s the 40-60 age group that is being hit with more severe illness this time,” they said.
“It’s a classic pandemic ‘wave two’ picture.
“Indeed the longest length of stay in Wrightington, Wigan and Leigh is in this age group – although the bigger volume is the 61-85-year-olds.”
It is understood Wrightington hospital has cancelled all but emergency, cancer and urgent elective surgery, while all surgical electives at Leigh have been halted too. At the time of writing no response had been received from the trust and it is unclear how long that decision will remain in place.
In Stockport, meanwhile, the hospital is particularly vulnerable to extra demand.
Stepping Hill regularly features at the bottom of national league tables for A&E waits each winter and has a physical capacity issue with an overcrowded estate. While government investment will see it expanded in the near future, that won’t come in time for winter 2020. Stockport also has comparatively high numbers of older residents.
As a result, agree multiple insiders, the area’s hospital may have less resilience than others as Greater Manchester heads into winter, although the hospitals do operate as a network in order to share pressures.
The Nightingale hospital in Manchester opened today and is expected to be used largely for people without Covid as a step-down facility – freeing up beds for Covid patients.
It is understood it will be staffed by a mixture of GPs, agency and bank staff, plus staff from existing hospital trusts, although it is unclear what the impact will be on individual hospitals as a result.
Each trust in the region was asked to comment, but none did so. It is understood all communications during the pandemic now have to go via NHS England, meaning requests to individual trusts are largely going unanswered.
Sarah Price, Chief Officer of the Greater Manchester Health and Social Care Partnership, said: “Hospitals across Greater Manchester are continuing to provide care for non Covid-19 patients and it’s important that anyone with concerns continues to come forward for help and treatment.
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“We are monitoring the situation with our hospital admissions, overall beds and ITU beds very closely.
“In Greater Manchester our hospitals pull together if there are particular pressures in any one area, to ensure the best care for patients, and that where one organisation starts to see issues with capacity, they care supported by their neighbours to manage that pressure.”
“As a result of the increases in Covid-19 admissions in our hospitals, it is important that we are continuing to provide services for our patients and patient safety remains of the highest importance’.
“We have a well-resourced and highly skilled critical care workforce in Greater Manchester and have taken learnings from Wave 1 of the pandemic to ensure that we provide the very best and safest care to everyone who needs it. We are better prepared; we’ve got better information and a better idea of how to share the workload and treat people with Covid-19.”
A spokesperson for NHS England in the North West said: “Coronavirus cases and hospital admissions are continuing to rise and so it is vital everyone does what they can to control the virus, particularly by following government guidelines.
“If the infection still spreads, hospitals have local and regional plans in place to respond to additional demand, including through using the Nightingale in Manchester, which will start to accept patients from today.”