Latest Welsh NHS data has revealed that bed occupancy for the most seriously unwell patients was as high as 140% over the festive period, with several health boards reaching their “functional” maximum capacity levels.
Around half of all these beds are currently taken up by patients who are suffering from the most serious effects of coronavirus and need specialist breathing support.
The lack of usable critical care beds has been compounded by a significant rise in staff absences which have reached record levels over the festive period.
An NHS Wales health system position report stated: “The level of staff absence has had a profound impact across frontline health services more recently, but none more so than in critical care.
“A number of health boards have reported significant Covid-related absence of their nursing staff in critical care – two health boards reported having in excess of 40 critical care nursing staff sick or absent in the last week [up to December 21].
“The impact on bed capacity is substantial as each critical care bed requires 24-hour nursing. Absence rates at [current] levels would mean each health board would have lost at least 13 critical care beds while absence rates remain at these levels.”
According to figures on the StatsWales website, Wednesday, December 16 was the day when the number of vacant critical care beds was at its lowest. Just 22 invasive ventilated beds were vacant across all Welsh hospitals, with 200 out of their normal capacity of 152 being occupied.
On this day Cwm Taf Morgannwg and Aneurin Bevan University Health Board had none of these beds vacant, meaning that some patients needed to be transferred to different intensive care units many miles away from their own communities.
To put this into context, just a month earlier on November 16 there were 119 vacant invasive ventilated beds, and in the first wave on May 16 there were 224.
In recent days, the Welsh NHS has reported a slight improvement in critical care occupancy, with 33 vacant invasive ventilated beds reported on Wednesday, December 30. But this has been partly caused by several patients dying with the virus and other illnesses.
Several health boards have already made the decision to halt all non-urgent appointments and procedures to focus resources on those most in need.
Three health boards are currently using their field hospital capacity and Aneurin Bevan University Health Board has opened the Grange University Hospital earlier than planned. However, it must be noted that these field hospitals are not housing critical care patients and are instead treating those recovering from coronavirus.
Ten ambulances parked outside The Grange University Hospital in Cwmbran at 11.20am on December 31, 2020
(Image: Ben Evans/Huw Evans Agency)
Dr Jack Parry-Jones, of the Faculty of Intensive Care Medicine (FICM) in Wales, said critical care capacity stands at 5.7 beds per 100,000 population – much lower than other European countries.
He told ITV Wales: “For example, Germany has 27 beds per 100,000 of their population and we can see that their response to the current pandemic is better.
“It’ll be better for a number of reasons but they certainly don’t have one armed tied behind their back when they’re trying to respond to a pandemic in a country that is under-provisioned for critical care services.”
Speaking in plenary on December 30, Health Minister Vaughan Gething said: “It is despairing and dishonest to claim there is lots of unused critical care capacity.
“Using critical care surge capacity comes at a real cost. Staff have to be transferred from other activity that cannot go ahead. Delaying or cancelling non-Covid care stores up harm that our NHS will have to return to, and sadly harm that our NHS may not have the opportunity to resolve.
“Our critical care staff have not had a break, and the awful truth is that patient flow out of critical care is not all good news. Some people do recover, however mortality rates are making a major contribution to freeing up beds.
“Current mortality rates for Covid patients in critical care show that in Wales nearly 40% of people admitted since September 1 have passed away.”