Page last updated at 23:24 GMT, Monday, 7 September 2009 00:24 UK

Critical care flu planning 'weak'

By Nick Triggle
Health reporter, BBC News

Andrew Lansley: Intensive care capacity "is not where it ought to be"

Critical care is the weak link in the government's swine flu emergency plans, the Conservatives have said.

Freedom of Information replies from 80% of hospitals in England show intensive care units were already under pressure before the pandemic, the party said.

The Tories added more beds were needed and also cited research suggesting demand at the peak of an outbreak could outstrip supply by 60%.

The government said it was working on plans to double the number of beds.

However, the Tories questioned why this information had not already been published.

'Best prepared'

The party acknowledged the country was among the best prepared for the flu pandemic, but said the emergency measures were let down by the critical care element.

The plans currently in place say that non-emergency care can be cancelled and doctors moved around the country to cope with problem hotspots.

But there is no specific detail about how critical care capacity could be increased and staff trained to care for severely ill patients.

If the second wave of swine flu occurs when schools return this could cause real problems
Andrew Lansley, shadow health secretary

There are more than 3,600 critical care beds in England, although just 2,000 of these are classed as level three, which are able to deal with the multiple-organ failure that the most severely ill flu patients can suffer.

The Tories said they found on average hospitals had all their level three beds full for nearly one third of the time.

They also found cases where beds had to be temporarily closed because of lack of staff and situations where patients were discharged early because of demands on the service.

To date, demands on intensive care from flu have been limited. Last week, there were just 31 in critical care, while even at the peak at the end of July there were only just over 60.

However, experts have predicted the situation will get much worse during the autumn and winter.

'Problems'

Shadow health secretary Andrew Lansley said: "If the second wave of swine flu occurs this could cause real problems.

"The government urgently needs to review its plans in order to help the NHS provide extra beds to deal with the pandemic and ease the pressure on intensive care units.

"It should look at how more staff can be trained in ventilation support and the idea of rest centres to care for patients who can't look after themselves at home."

Bruce Taylor, of the Intensive Care Society, said he too was concerned.

"Most of the points made here are compatible with what we said at the beginning.

"At least people are now listening and you have to give credit to the Department of Health, but it's possibly slightly unrealistic in its plans for how much we can expand capacity."

The Department of Health said the 60% figure cited by the Tories, which came from a report in the journal Anaesthesia over the summer, was based on a much worse outbreak of flu than the government was expecting.

Ian Dalton, national director for NHS Flu Resilience, said: "Critical care is and always has been key to our planning.

"We have asked the NHS to double capacity if needed and plans are well advanced in every region to do this - a proportionate response based on what we know about the virus."

And he added: "This could be a tough winter, but plans are stronger than ever before, and the NHS is used to being flexible in dealing with increased pressure."



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