If last week’s battle against Greater Manchester’s ‘level three’ restrictions was a local aspiration for more money, ministers are now seeking to reject the debate.
On Fridays, weekends and today again they are determined to highlight the pressures within the hospital system here to emphasize the need for new restrictions.
This includes the Prime Minister’s remarks that the number of intensive care patients with covid here is now 40 pcs higher than the peak of April, predicting in a parliamentary lobby briefing today that we will be completely out of the ICU bed by next November 12.
In response, the Greater Manchester film insists – albeit not well – that it is being exaggerated.
On Sunday Andy Burnham Andrew Murray showed that the situation was being ‘exaggerated’ by the number 10, when Stockportport Council leader Alice Wilson told the broadcast media this morning that the ICU occupation would actually be only wherever it is at any time of the year.
Yet to understand the exact dimensions of the pressures and the political arguments, different levels of hospital-level data are needed. In recent weeks this has not come to fruition, as the pressures within the system have clearly increased.
So this morning, MEN sent a uniform list of questions to all the key players in the row.
We wanted a confidence-based covid admissions number as a ratio of overall affordability to the top of April. We wanted to break down the same images for ventilator beds with intensive care and high-dependence beds, more aggressive ventilation.
And we wanted the same amount of bed occupancy figures for this time last year, so that we could compare it to the start of a typical winter.
Furthermore, we asked if the data was properly ‘owned’, an annual question that seems to have prevented us from getting trust-level information when we requested a similar number in September.
Our request was sent to NHS England, the Greater Manchester Health and Social Care Partnership, Confidence in Each Hospital Conference, the Department of Health and Social Services, the Mayor’s Office and Downing Street. We gave the deadline at 4 p.m.
Six of the seven relevant NHS trusts did not respond. Wigan, Wrightton and Leigh said ‘we can’t provide statistics – these will be released nationally’, to which no one else responded.
MEN understands trusts have asked both the regional NHS England and the Greater Manchester system not to publish their own figures, especially in the media.
The Greater Manchester Health and Social Care Partnership responded this afternoon by saying that Dr Jane Edelston would be conducting a pool interview with the Press Association about the image of the hospital here. However, Maine’s specific questions have not been resolved.
The mayor’s office did not respond.
The Department of Health and Social Services responded almost immediately this morning, saying the NHS England contained the data.
NHS England responded with some links to the data.
However most of the relevant information provided by it was only divided at the northwest level, which is important.
The government’s argument is about Greater Manchester in particular, so the numbers in the North West are not good – especially given the situation in Liverpool.
Nonetheless, one statistic of covid-related hospital admissions and patient diagnoses provided at least hospitality-based separation.
It shows that on October 11, 76 new covid patients were recorded in the entire hospital here.
This compares to 240 on the top day of April, according to the MEN analysis of government data, the number of patients – a little over a week ago – is one-third where they were.
The highest number of penine acute fidelity was 22, a. It should be noted, however, that Penn covers Royal Oldham, Fairfield and North Manchester General Hospital – hence three separate hospitals.
The Manchester Foundation Trust had 19 patients, but again, there are two major hospitals under the umbrella of MFT: Manchester Royal Infirmary and Whithensway. So it is impossible to work out which individual hospital has the most stress, even if you know what their actual capacity is. Which we do not.
Statistics by already ICU, high dependence or the number of patients required for ventilators do not break the picture.
So ICU, what is the government’s argument?
Downing Street responded to Maine’s request for information, but it provided our own selection of information and not the range of numbers we wanted.
Greater Manchester has seven relevant hospital trusts. The number ten has provided four numbers.
It said the ICU of the Manchester Foundation Trust is in the 70th PC acquisition; Bolton at 81pc; Salford at 91pc; And Stockport 100 pcs.
Its statistics, its looks are quite alarming. However, a senior hospital clinician explained that on paper their ICU capacity is not necessarily what it is in reality.
In fact, hospitals also have ‘intensity’ capabilities – in other words, they can stand in more beds. They can transfer patients to other trusts, even within greater Manchester and the North West.
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“We are still in a position where if people need ventilation or need access to a ventilator, we can deliver it to greater Manchester and there are plans to increase ventilator capacity such as in March and April,” they noted.
“We have done this by transferring GM to other boroughs or opening capacity in individual hospitals. So the claim ‘ICU is full,’ does not mean that you cannot ventilate patients if they need ventilators.
“Have a street conversation with your ICUs and say‘ we got a patient ’.
And a senior health person agrees.
“Well Stockport’s ICU may be‘ full ’, but that’s not uncommon, but Stockport’s catchment area includes East Chishire and the high peak up to Boston,” they said.
“That’s also why we have an ICU network across the Northwest, so that ICU capacity can be increased to increase demand. Also, the absence of staff can not only affect bed capacity but also increase patient flow.
“My number ten suspicion is that if you live on a bus and need ICU care, you can only get it at your local hospital and if it is ‘full’, you will not get an ICU bed … not that patients do not need ICU urgently. Care is regularly transferred to the nearest available ICU bed. “
This evening, Dr. Adelson, who appears to have used both local and national management as a spokesman, made a similar statement.
“The system can handle that,” he said. “It would be a mistake to think ‘oh gosh’ if one looks at the statistics completely, but it does not take into account the extra power that will be effective.
“They didn’t know about all our plans to raise. We’ve got a very detailed escalation plan. We’ll bring more beds to play.”
“We’ve put provisions, we’ve put a lot of our beds in covid-protected facilities.
“As a result, the number of beds available at any one time is dynamic.”
MAEN had already returned to Downing Street asking if their ability to increase numbers – and the ability to evacuate patients around the hospital network – had been taken into account. No response was received at the time of writing.
The Greater Manchester system and NHS England did not provide their ICU data in response to Downer Street statistics, although one senior figure said they did not recognize them.
And one of the arguments in the region is that no organization today is willing or able to provide an equal breakdown for this year, even though the numbers are broadly comparable.
So it has been, even after nine hours of trying to get to the bottom of it, it is impossible to provide a reliable and detailed picture of the capacity of our hospital, even though it is at the center of an angry political line.
And it would be a mistake to suggest that only Downing Street is providing full data or that the system here is not under pressure.
MAEN spent ten days in late September trying to figure out what the system’s internal estimates for the hospital were.
When the numbers were finally leaked – they were never officially released – they showed that Public Health England believed Greater Manchester would reach its peak in April on a hospital basis by the end of October.
Apparently this leak was the cause of an internal investigation, it was a concentration. Yet these predictions do not appear to be a specific reason why they simply cannot be published.
In fact, an internal dashboard provided to some seniors shows real-time – or at least daily – admission by faith. So they exist and they are being publicized, but they never come out publicly.
We know that across the Greater Manchester system as a whole, admissions have increased – last Tuesday a two-thirds increase in the week, with Greater Manchester being published in one week as data released in Greater Manchester. ICUs and highly dependent patients were one-third across the system.
There is a widespread expectation that alternative surgery may need to be scrapped at some point, despite a wide and growing backlog, but as it stands, the number of Kovid patients continues to rise and hospitals continue to run business as usual.
“It’s really busy,” said a hospital director.
“Our numbers are very similar to the number we had in April. So in some GM hospitals, we are no less than we were when the situation was the worst. “
It remains to be seen what the nightingale is for, or how it works.
“I guess we don’t know yet, although I can very well assume that we’re not going to use it to wind people up,” they said.
“The reason for the limitation is not the number of ventilators or kits, it is the labor force. These are ICU consultants and ICU nurses. So the reason you limit the amount of people you can ventilate is because of the combination of manpower and the oxygen they carry. “
Andy Burnham and Sir Richard Liz released a statement this evening criticizing the government for using “electoral statistics”.
“We are disappointed that the government today tried to raise public concerns about the NHS in Greater Manchester with election statistics,” it said.
“Greater Manchester’s ICU occupancy rate is not uncommon for this time of year and is comparable to the occupancy rate in October 2019.
“Also, providing information about individual hospitals does not replace the fact that our hospitals act as a demand management system.
“We are not complacent about the location of our hospital and are closely monitoring the situation. In the current context, however, we believe that our residents should be given clear, accurate information about the state of the NHS in Greater Manchester, and that public fears have not been raised unnecessarily. “
With Monday’s shutdown, politicians are at a standstill. People here are watching with concern, wondering what will happen and what this winter will really mean for them and the NHS.
In the meantime the battle of words over what happened after Greater Manchester continues, when every part of the English system sits in numbers behind their reasoning.
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