The Faculty of Intensive Care Medicine welcomes the Government’s publication of the Delivery Plan for Tackling The COVID-19 Backlog of Elective Care, setting out how the NHS plans to recover the record elective surgery backlog of 6 million patients across the UK.
The Faculty welcomes the plan’s recognition that many of these patients will, following their surgery, require access to an intensive/critical care bed. The plan notes that hospitals may choose to increase critical care capacity to meet the ongoing response to COVID-19 as well as to recover elective backlogs. However, an increased number of critical care beds is an inadequate solution without the properly trained workforce to cover them.
Critical care was facing a capacity crisis in the UK before the arrival of COVID1 - the pandemic has only exacerbated these issues, as well as placed enormous burden on the existing ICU workforce.2 Sadly, this has not been reciprocated in how they feel valued. Consequently, many units have seen a loss of critical care staff, particularly nursing staff. Staff education and attainment of key skills need to be pushed higher up the agenda. Attainment of skills should be financially rewarded.
The Faculty notes the plan’s reference to “more training for key allied health professional groups in critical care”. The Faculty has been at the vanguard of this work for many years, including setting the national curriculum for Advanced Critical Care Practitioners3. It is vital that any such workforce expansion must not compromise the high standards set by ACCPs, not come at the expense of the much-needed expansions of both the ICU physician workforce and medical intensive care training posts.
The Faculty also welcomes the plan to improve patient care pathways and would urge local sites to drive the creation and delivery of Enhanced Care services4 for patients whose care needs fall into the gap between what can be provided on a normal ward and on ICUs.
Dr Daniele Bryden, Vice-Dean of the Faculty, said:
“The COVID-19 pandemic has exposed the ways in which intensive care services in the UK have been under-resourced for many years. The huge increase in ICU capacity delivered to deal with COVID came at enormous cost to those working in critical care and relied on assistance from many other specialties across the medical profession. Whilst we welcome the recognition that ICUs will be essential to the elective backlog recovery, this will not be achievable or sustainable without significant investment in and expansion of the medical critical care workforce. The Government needs to set out how it will address this need.”