Some hospital trusts in London are beginning to cancel non-urgent elective procedures and redeploy staff, as absences rise ahead of an expected wave of admissions from omicron.
However, senior sources at several other trusts in the capital said they were not yet taking that step despite the expectation of major pressures. Several said absences were now rising, leaving gaps, due to the rise in covid cases.
National guidance early this week acknowledged routine electives were likely to be cancelled, but did not set a rule, instead saying “capacity should be maintained as far as possible, recognising the requirement to release staff to support the vaccination programme and respond to the potential increase in covid-19 cases”. It went on to say “clinical leadership and judgement about prioritisation and risk will be essential”.
The chief executive of south east London’s Lewisham and Greenwich Trust, Ben Travis, told staff in a video message they could be redeployed into different clinical areas and that those working in corporate divisions could be asked to work on the frontline.
He said the key priorities would be vaccine delivery, emergency care, and people needing operations within 28 days (ie P1 and P2), including those with cancer.
“During the last week, we have been facing significant challenges, with many staff going off due to covid,” he said.
“We are very mindful of the current staffing situation and the likelihood of significant spread of the omicron variant across our workforce so we will be making difficult decisions in order to safely deliver our urgent and emergency pathways,” he said.
The trust is seeking to coordinate its plans cross south east London and is reviewing each service line to see how it can support urgent and emergency care, he said.
For some, it would involve stepping down non-urgent care so staff can be redeployed, with the majority of clinicians who are not currently involved in frontline delivery also being asked to return to the floor, Mr Travis said. Many colleagues working in corporate divisions will be asked to work on the frontline, he added.
A well-placed source at another large London hospital trust confirmed it was moving to cancel routine operations as well as beginning to redeploy some staff. They said that, with growing absences linked to omicron, the staff freed up could be redeployed to fill gaps to keep the most urgent activity going. Some staff are also being lost from normal work to go to work on vaccination, they said.
However, a director at another trust in London – and at several acute providers outside the capital – said they were not yet cancelling any future elective activity on the basis of omicron, preferring to wait for longer to see if it starts to translate to a surge in admissions.
Covid cases have been rising rapidly in London, most of them now omicron, particularly among working age adults, and covid admissions are also on the up.