© Provided by The GuardianPhotograph: Facundo Arrizabalaga/EPA
Seriously ill Covid patients are being transferred from overstretched London hospitals to intensive care units almost 300 miles away in Newcastle, the Guardian can reveal.
The crisis engulfing the capital's hospitals is so severe that in recent days patients have also been moved 67 miles to Northampton, 125 miles to Birmingham and 167 miles to Sheffield.
NHS England has told hospitals in the north of England, the Midlands and other areas to open up hundreds of extra ICU beds to take patients from London, the south-east and east, where the new variant has pushed Covid hospital admissions to new levels.
It is the latest dramatic illustration of the increasingly difficult situation confronting the health service. Hospitals across the UK are battling to provide care for 36,489 people with Covid, an increase of 5,872 in seven days.
Dr Claudia Paoloni, president of the Hospital Consultants and Specialists Association, said the long-distance transfers put patients at risk, and the huge number planned showed that the NHS was "on the ropes" after years of underfunding and staff shortages.
"Hospitals have already spread intensive care teams more thinly, with nurses juggling three or four seriously ill patients at a time instead of the usual one. They have expanded intensive care departments into every available space and redeployed specialist staff to cope," she said. © Photograph: Facundo Arrizabalaga/EPAAmbulances parked outside the Royal London hospital on Thursday.
"The fact that all this is not enough and they are still having to take the extraordinary step of transferring critically ill patients hundreds of miles reflects the unprecedented gravity of the situation facing our NHS. No one would consider doing this unless the situation was exceptionally bad, usually because specialist treatment is unavailable or staffed critical care beds had run out."
On Monday Boris Johnson said the health service was in "a race against time, because we can all see the threat that our NHS faces, the pressure it's under, the demand in intensive care units, the pressure on ventilated beds, even the shortage of oxygen in some places".
Video: Dr Hilary reveals the level of protection following first dose of Pfizer vaccine (Wales Online)
Critical care doctors in Newcastle are concerned that the ICUs at the city's Royal Victoria and Freeman hospitals will not be able to cope with the influx of patients from London because their units are already so full of local people. Hospitals in the north-east and Yorkshire are treating 3,476 Covid patients, more than at any other time in the pandemic, according to the Health Service Journal.
NHS bosses are also considering transferring London Covid patients receiving potentially life-saving care to hospitals in Coventry, Wolverhampton, Leicester, Nottingham and Derby, all of which have large ICUs.
In addition, some Covid patients in intensive care in Birmingham have been taken to Newcastle to free up beds for patients transferred from the capital.
All transfers are understood to be taking place in ambulances that are specially equipped to deal with patients who are medically vulnerable. But Paoloni, an NHS anaesthetist, said such transfers could put patients in danger.
"It means skilled staff being taken away from hospitals for a prolonged period and is very risky for patients. It risks dislodging drug lines and ventilation supplies, and if something goes wrong on the road, there is no backup. Medically, it is truly a last resort. It also means that patients will be left hundreds of miles away from families in a lockdown."
She added: "We have to be blunt. Our NHS is on the ropes because of years of understaffing, under-resourcing and the failure to call a full lockdown earlier. The lessons from the heartbreaking crisis now facing the NHS, its staff, patients and their families must be learned. Never again can we allow ourselves to be placed in this unforgivable position."
Hospitals that run short of ICU beds usually transfer patients to another hospital nearby, which is usually in their own critical care network. They can transfer patients outside their network or even their region of England, but before the pandemic struck, that was rare.
One intensive care consultant said: "Hospitals have been practising mutual aid recently, especially since new year. We've been transferring patients longer distances, and that's been working well. The number of out-of-network transfers is going up."
Last week the UK's four chief medical officers said many parts of the health system in the four nations were under immense pressure and there was a "material risk of the NHS in several areas being overwhelmed over the next 21 days". They said the large number of people becoming infected and needing hospital treatment, including in intensive care, was to blame.
Several hospitals in London have come close to falling over in recent weeks. The number of Covid arrivals forced the Royal London hospital to go into "disaster medicine mode" just before the new year, which it admitted led to a drop in standards of care.
International research has shown that before the pandemic, the UK had one of the smallest numbers of ICU beds per 100,000 people among developed nations. Germany had 29 such beds per 100,000 population and the US had 25, while Britain had just 6.6.
Lucy Watson, chair of the Patients' Association, said: "Moving intensive care patients long distances across country is a clear indicator that the NHS in London has been overwhelmed by Covid-19. Family members of people whose life is saved by intensive care services far from home will no doubt be grateful, but at such a worrying and frightening time, the role of family liaison workers maintaining contact between patients, their families and clinicians will be all the more important.
"This will be particularly so for those whose loved ones die far away, which will make a hard situation even harder."
The Department of Health and Social Care has been approached for comment.