Doctors must be trusted to care for every patient without judgment and everyone else to help protect the NHS
The situation in UK intensive care units (ICUs) is grave. Across the UK, units are under immense pressure and are as busy or busier than they were in the first wave. All plans enacted over the summer to provide support for critical care services going into winter pressures have been stretched and then stretched again. Stories from exhausted staff and overcrowded wards, particularly in London, show how close to breaking we are. Both the prime minister and the CEO of the NHS, Simon Stevens, have raised the spectre of critical care treatment becoming limited if demand exceeds supply.
We went into this pandemic with fewer staffed, funded critical care beds compared with other developed nations. Germany has 29 ICU beds per 100,000 population, the US around 25, the UK 6.6. The Faculty of Intensive Care Medicine, the professional body responsible for all doctors working in intensive care in the UK, had highlighted this and possible solutions in its critical condition and critical futures reports. More training in intensive care skills for healthcare staff and better ways of identifying the workload that an intensive care nurse can safely do were issues we highlighted. There has not been the wholesale development of services that was needed and which would have helped us cope better in this pandemic; intensive care was just another competing healthcare interest in an NHS with a limited budget.
