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Welsh intensive care doctor says it feels like patients receive 'third world service' – Wales Online

Doctors say the potential situation in January with the combined pressure of Omicron and winter is “extremely worrying”.
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An intensive care doctor in Wales has compared patient care in hospitals to a "third world service" due to lack of capacity, and fears the NHS might not "cope" with the combined pressure of winter and the Omicron variant.
Speaking on BBC Breakfast this morning, Dr Ami Jones, an intensive care consultant in Abergavenny, said patients have been denied intensive care beds after surgery because they are full.
She added that hospitals are "constipated" with patients, with "no flow", as staff are struggling to discharge people who no longer require acute care.
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Dr Jones also said hospitals "don't have enough staff" and are instead forced to "constantly" rely on agency staff.
Meanwhile, speaking on BBC Radio Wales, Dr Richard Pugh, Chair of the Welsh Intensive Care Society, said hospitals are still feeling the effects of the autumn Covid wave, and warned that hospitals could be "extremely stretched" from December until February, even if the number of people who become "severely ill" with the new variant is low.
"What we're potentially facing in January is extremely worrying," he said.
The doctors' words come as the UK's Covid Alert level has been raised to to Level 4 following a rapid increase in recorded Omicron cases.
There are currently 15 cases of the new variant in Wales, with one person in hospital.
In an interview on BBC Breakfast, when asked what the current situation is like in ICU where she works, Dr Ami Jones said the "whole hospital is bursting", especially the accident and emergency units.
"We're really struggling to get patients out of hospital who don't need acute care anymore, so there's just no flow in the hospital. The hospitals are constipated, we can't move patients through. Obviously there are Covid patients. They don't take up all of my work, but they take up a proportion of my work, and I think that's the same throughout the hospital," she said.
"As soon as you have Covid patients to look after, that creates an inherent workload because they have to be kept separate and PPE etc. So we're just very busy and looking forward into winter and Omicron coming, we wonder how we're going to cope."
Asked about the proportion of Covid patients in intensive care who weren't double jabbed, the doctor estimated that they made up about half of the overall number.
"Some people are very staunch anti-vaxxers and don't believe vaccination is the way forward, some people said they didn't get round to it or they were just waiting to see and they were just worried about it. And that's very difficult because you feel like it's a treatable disease potentially," she said.
Dr Jones said it was "awful" to have to explain to people that they can't be treated due to the lack of hospital capacity.
"You feel like you're giving them a third world service. We have people who need an intensive care bed after their operation that we can't do – because the beds are either full of Covid patients, or they're full of people that we can't get a ward bed for because there is no capacity in the hospital," she said.
"We don't feel like we're doing people a good service and that is really hard for the staff. We want to feel like we're doing the best for everybody. And that's part of why everyone feels so bad about the situation at the moment within the workforce. It's awful, and it's very hard to see how that's going to change in the next few months."
The consultant added that her colleagues are "pretty broken and tired".
"It's been a tough couple of years. We've lost a lot of staff. We're constantly having to rely on agency staff, because it's just so busy and we just don't have enough staff. I think we all look at each other wondering, 'how are we going to get through this year? How is the NHS going to be in one piece at the start of next year'."
She believes the "tipping point" will come in January, with Omicron exacerbating the existing pressures of winter.
"Either Omicron puts us on our knees or January is always the busiest, busiest time. It's that historically, isn't it? And it's just the impact of Omicron on top of that, and the impact of social care crumbling," she said.
"The biggest problem for us, really, is we've got hundreds of patients in our health board that are in acute beds that we cannot get out of hospital because they need more care than they had before they came in, and the system is just absolutely stuck. There is just no flow, and I think unless we improve that, when we get the deluge of the standard January patients, plus Omicron, I don't see how we're going to sustain, I don't see how that's going to happen."
Dr Jones called for a "significant boost" to social care, with more funding, and improved working conditions and pay. She also appealed to the public to "go and get your vaccinations, get your boosters, think really carefully how you behave over the next few weeks".
"Christmas could really be ruined and certainly if Christmas isn't ruined, January is going to be really really tough," she said.
Also speaking this morning on BBC Radio Wales, Dr Richard Pugh, Chair of the Welsh Intensive Care Society and and intensive care consultant at Glan Clwyd Hospital near Rhyl, said he was feeling "apprehensive" about the current situation.
"From a critical care point of view, we're still feeling the effects of the autumn Covid wave, which has been bigger and has lasted longer than we anticipated. Even back about a month ago, 40% of our critical care beds were occupied by patients unfortunately suffering from Covid illness. We're down to about 20% of our overall beds now. But it is difficult to manage all of the competing demands. We always anticipated this winter would be a difficult one, but the scale of the concern with regards Omicron is not really something we had seriously considered up until relatively recently," he said.
According to Richard, the NHS could struggle to cope even if the number of hospitalisations due to the variant are "relatively low".
"The overall transmission rate seems like it's going to affect us quite significantly. And even if the overall proportions of individuals who contract the new variant, even if those numbers who become severely ill, are relatively low, we're still looking at absolute large numbers and our health care services could obviously become extremely stretched over December, January and going into February"
Asked how hospitals will cope this winter, he also warned of a "dminished workforce".
"Each health care service is looking again at their escalation winter surge plans. We know we've got a finite resource, and that resource could be affected by staff sickness and potentially the rules around self-isolation as well, so we're potentially facing this with a diminished workforce and facing additional remands with the backlog of other activities as well."
He added that hospitals might have to prioritise treating individuals with the most "life threatening problems" in order to "mitigate the situation".
Dr Pugh believes the Welsh government has taken the right approach with the increased frequency of review meetings, as the "rate of change is significant".
"What we anticipate from previous experience is that any significant change to the way that we live our lives day to day can take two to three weeks to have an impact upon hospitalisation, critical care admissions, even if those interventions are quite significant," he said, adding, "It's going to have to be a very responsive approach to this"
Asked if stricter measure should be reintroduced, Dr Pugh anticipated by late December and January "we are going to have to be considering those sorts of measures" and insisted that we can't "rule out any options at this stage" as data is still be accumulated.
With regard to staff wellbeing, he echoed Dr Jones.
"It's difficult. The staff are frankly exhausted and keep hoping the latest wave will be the last big one. What we're potentially facing in January is extremely worrying"
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