NHS leaders accused of pressure on hospitals over critical incidents as Covid grows

NHS leaders have been accused of downplaying the impact of the Covid crisis and scrutinizing hospitals for reporting critical incidents and delaying operations.

A leaked email calls on hospitals to use “correct terminology” and to provide advance notice to NHS leaders before disclosing their status.

Sources said the message was a “thinly veiled threat” and that there was “subtle pressure” amid the rapid spread of the Omicron variant.

At least 25 trusts have reported critical incidents this week, including one in Northamptonshire on Friday afternoon, while new figures show a 59% rise in absenteeism in just seven days.

Trusts in London have been told hospitals will be investigated for reporting a critical incident if there is “doubt” about the decision, according to an internal email sent by NHS England on Wednesday.

In light of the media coverage, it would be “valuable” to “raise awareness of key terminology and encourage you to ensure you are clear…when considering a statement,” it said. “National oversight of the statement on incidents has been tightened…and [senior managers] In case of doubt about the status of an incident, an organization will have to conduct additional investigations.”

Shadow Health Secretary Wes Streeting said: “We know the NHS is under tremendous pressure and it is important that local trusts can be fair and open to Parliament and the public about the challenges they face. We are increasingly concerned that ministers will become more are more interested in covering up problems than in solving them.”

Daisy Cooper, the Lib Dem Health spokesperson, said: “This is an insult to every health professional who has given their all, and to every patient with canceled appointments and delayed surgeries.

“We have to trust health chiefs when they say a situation is critical. Every NHS patient and health professional can see for themselves that this is a health service struggling under the full weight of the Omicron wave. They need support, not suspicion.”

A source of confidence said the email came across as “bullying” and another in the Midlands said there was “subtle pressure” from NHS England not to report incidents – although hospital sources in other parts of the country said NHS England was supportive .

Another NHS source from a trust in the north of England, where the number of Covid patients in hospital is now approaching the peak of the second wave, said the message appeared to be a “thinly veiled threat”.

NHS England explained in its email that a critical incident occurs when “the level of disruption causes the organization to temporarily or permanently lose its ability to provide critical services, patients may have suffered harm or the environment is unsafe and requires special measures and support from other agencies to restore normal business functions.”

A major incident – the next level – is anything that “poses a serious threat to the health of the community” or causes a level of casualties that requires special arrangements.

In a statement, an NHS spokesperson said: “It is absolutely correct that organizations use the definition of an incident consistently across the country so that appropriate support and mutual assistance can be provided when needed and so patient care can be maintained, and to suggesting that this email was sent for a different purpose is wrong.”

Concerns have also been raised that trusts are under pressure from NHS England to continue planned operations, with hospital leaders saying they are experiencing difficulties in stopping non-emergency services.

Senior hospital sources have warned national and regional NHS directors are putting pressure on them to “deliver” and maintain elective care despite rising staff shortages and have accused leaders of trying to “manage the message”.

A trust chief said: “We find that we have to go through a lot of processes to do away with electives and even then we don’t stop it completely.

“Some trusts are just doing it under the radar because they think they won’t get support, but we’re here on the ground and we know best what the situation is.

“The command and control position for emergencies” [from NHS England], is more about managing the message than about actually offering practical support.

“What really shocks me is how little is said about these issues, we are constantly focusing on how many people are infected and not how many people have waited and suffered damage from not getting an ambulance, how many people GP practices cannot provide routine service, how many patients are in the hospital that shouldn’t be there.”

“It really amazes me how little is said. It’s the way the regional and national communications teams behave to keep provider executives out of the media, as they may be headed by the Ministry of Health and Social Care and not want to spread this message.

A senior source at NHS Trust in the east of England said: “There are probably more trusts in the area of ​​reporting critical incidents than being advertised. There may be a significant number now on the brink, who have already clicked internally printed…

“The situation in the NHS feels quite tense, not only in terms of the pressure on services, but also the pressure on trusts to deliver.”

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