| Tier 2 / Tier 3 13:15 - Oct 15 with 34769 views | aleanddale |
Matt Hancock hitting a new level of incompetence today in the commons.
Press leaks prior to confirmation with local authority.... then backtracking.
Dithering over a statement on Manchester and Lancashire regarding if and when we will move to tier 3.
No doubt the whole thing is complicated beyond belief BUT there should be much clearer / decisive communication and direction from the government.
Staff on minimum wage will be getting 2/3 or just over £5 an hour on this latest job support scheme that's replacing furlough. Minimum wage is just that the minimum required to survive.
Liverpool the ONLY city on tier 3. Honestly?
Ignoring the "Science" when the science advised a NATIONAL circuit break 3 weeks ago.
My two penneth is that this is set for the long term. I read an article saying the average life expectancy is 81 and the average Covid death age is 82. It is a very very tough decision to make i do understand that but everyone knows this and the day could arrive where shielding becomes self governing and everyone makes there own choices. Maybe new Covid Laws need to be applied to allow the nation to do that and the obvious rule breakers can be hit with more severe penalty.
This is one mighty mess and the problem is that the master plan is falling well short its time for a rethink and quickly. |  | | |  |
| Tier 2 / Tier 3 on 11:41 - Oct 19 with 2449 views | tony_roch975 |
| Tier 2 / Tier 3 on 10:51 - Oct 19 by aleanddale |
Andy Burnham taking a lot onto his own shoulders here..
Manchester could rocket up the Covid league table if we are not careful and we could end up in Lockdown for a lot longer than a 2 week circuit break. We are all in for a terrible run now until the end of the year i fear.
Boris obviously wants all the local authorities on board with his plan hence the willingness to negotiate regionally.
Interesting week this week as half term for many starts on Friday. |
From BBC website:
"Analysis box by Nick Triggle, health correspondent
Hospitals in the North West are incredibly busy, but talk of them being overwhelmed with Covid patients is somewhat premature.
In the spring the number of admissions across the region went from under 100 a day to over 400 in the space of a week.
Cases have been rising much more gradually in recent weeks. In fact there are signs they may have started levelling off at around 200 cases a day.
The hospitals in and around Manchester and Liverpool have borne the brunt of the pressures. Particular concern has been expressed about intensive care, with reports that more than 80% of beds in Manchester are occupied.
That is not unusual - last winter similar occupancy rates were seen.
In fact, this is one of the difficulties the NHS faces with Covid - it works so close to capacity in normal times that an extra pressure causes real problems.
But again the local NHS is not yet in the position it was in the spring when it had to take emergency measures to open up extra intensive care beds by cancelling non-Covid work.
What happens in the coming weeks will be crucial."
Seems to back up isitme's data but also raises the issue of why we've allowed our NHS to have so little spare capacity? | |
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| Tier 2 / Tier 3 on 11:53 - Oct 19 with 2423 views | aleanddale |
| Tier 2 / Tier 3 on 11:41 - Oct 19 by tony_roch975 |
From BBC website:
"Analysis box by Nick Triggle, health correspondent
Hospitals in the North West are incredibly busy, but talk of them being overwhelmed with Covid patients is somewhat premature.
In the spring the number of admissions across the region went from under 100 a day to over 400 in the space of a week.
Cases have been rising much more gradually in recent weeks. In fact there are signs they may have started levelling off at around 200 cases a day.
The hospitals in and around Manchester and Liverpool have borne the brunt of the pressures. Particular concern has been expressed about intensive care, with reports that more than 80% of beds in Manchester are occupied.
That is not unusual - last winter similar occupancy rates were seen.
In fact, this is one of the difficulties the NHS faces with Covid - it works so close to capacity in normal times that an extra pressure causes real problems.
But again the local NHS is not yet in the position it was in the spring when it had to take emergency measures to open up extra intensive care beds by cancelling non-Covid work.
What happens in the coming weeks will be crucial."
Seems to back up isitme's data but also raises the issue of why we've allowed our NHS to have so little spare capacity? |
Years and years of cuts in the NHS at ground level whilst the fat cats at the top were awarded 6 figure salaries.
I guess we have nightingale to fall back on, i suspect it could be needed this time around. | | | |
| Tier 2 / Tier 3 on 12:22 - Oct 19 with 2382 views | isitme |
| Tier 2 / Tier 3 on 11:41 - Oct 19 by tony_roch975 |
From BBC website:
"Analysis box by Nick Triggle, health correspondent
Hospitals in the North West are incredibly busy, but talk of them being overwhelmed with Covid patients is somewhat premature.
In the spring the number of admissions across the region went from under 100 a day to over 400 in the space of a week.
Cases have been rising much more gradually in recent weeks. In fact there are signs they may have started levelling off at around 200 cases a day.
The hospitals in and around Manchester and Liverpool have borne the brunt of the pressures. Particular concern has been expressed about intensive care, with reports that more than 80% of beds in Manchester are occupied.
That is not unusual - last winter similar occupancy rates were seen.
In fact, this is one of the difficulties the NHS faces with Covid - it works so close to capacity in normal times that an extra pressure causes real problems.
But again the local NHS is not yet in the position it was in the spring when it had to take emergency measures to open up extra intensive care beds by cancelling non-Covid work.
What happens in the coming weeks will be crucial."
Seems to back up isitme's data but also raises the issue of why we've allowed our NHS to have so little spare capacity? |
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| Tier 2 / Tier 3 on 12:37 - Oct 19 with 2333 views | D_Alien |
| Tier 2 / Tier 3 on 11:41 - Oct 19 by tony_roch975 |
From BBC website:
"Analysis box by Nick Triggle, health correspondent
Hospitals in the North West are incredibly busy, but talk of them being overwhelmed with Covid patients is somewhat premature.
In the spring the number of admissions across the region went from under 100 a day to over 400 in the space of a week.
Cases have been rising much more gradually in recent weeks. In fact there are signs they may have started levelling off at around 200 cases a day.
The hospitals in and around Manchester and Liverpool have borne the brunt of the pressures. Particular concern has been expressed about intensive care, with reports that more than 80% of beds in Manchester are occupied.
That is not unusual - last winter similar occupancy rates were seen.
In fact, this is one of the difficulties the NHS faces with Covid - it works so close to capacity in normal times that an extra pressure causes real problems.
But again the local NHS is not yet in the position it was in the spring when it had to take emergency measures to open up extra intensive care beds by cancelling non-Covid work.
What happens in the coming weeks will be crucial."
Seems to back up isitme's data but also raises the issue of why we've allowed our NHS to have so little spare capacity? |
During quieter times, you can't have large numbers of ICU beds and just as importantly, ICU-trained staff just waiting around for patients to turn up, that'd be a ridiculous waste of resources. And it's not as if they can easily be redeployed since demand can suddenly spike - if there was a major road traffic accident with multiple casualties, for instance
Current capacity (pre-Covid) was carefully balanced to ensure enough was available, although it's constantly under review
[Post edited 19 Oct 2020 12:42]
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| Tier 2 / Tier 3 on 13:05 - Oct 19 with 2298 views | TipperaryDale |
| Tier 2 / Tier 3 on 12:37 - Oct 19 by D_Alien |
During quieter times, you can't have large numbers of ICU beds and just as importantly, ICU-trained staff just waiting around for patients to turn up, that'd be a ridiculous waste of resources. And it's not as if they can easily be redeployed since demand can suddenly spike - if there was a major road traffic accident with multiple casualties, for instance
Current capacity (pre-Covid) was carefully balanced to ensure enough was available, although it's constantly under review
[Post edited 19 Oct 2020 12:42]
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Genuine question; what do they do then, lay nurses off when it's quieter? How do they ensure there's enough beds and nurses during busy times, without leaving lots of bed and nurses "waiting around" during quiet times of the year? |  | | |
| Tier 2 / Tier 3 on 13:09 - Oct 19 with 2289 views | BigDaveMyCock |
| Tier 2 / Tier 3 on 12:22 - Oct 19 by isitme |
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Joshi Hermann has provided some statistics re critical care bed numbers from October 2019. Can I ask on what basis do you believe these statistics to be true?
They may or may not be but surely some scrutiny is required before you believe them? Like what’s his source and are they part of a wider set of statistics. [Post edited 19 Oct 2020 13:11]
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| Tier 2 / Tier 3 on 13:17 - Oct 19 with 2271 views | isitme |
| Tier 2 / Tier 3 on 13:09 - Oct 19 by BigDaveMyCock |
Joshi Hermann has provided some statistics re critical care bed numbers from October 2019. Can I ask on what basis do you believe these statistics to be true?
They may or may not be but surely some scrutiny is required before you believe them? Like what’s his source and are they part of a wider set of statistics. [Post edited 19 Oct 2020 13:11]
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NHS England is his source. There is link to the full data set in the embedded tweet above.
Also
[Post edited 19 Oct 2020 13:21]
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| Tier 2 / Tier 3 on 13:25 - Oct 19 with 2234 views | D_Alien |
| Tier 2 / Tier 3 on 13:05 - Oct 19 by TipperaryDale |
Genuine question; what do they do then, lay nurses off when it's quieter? How do they ensure there's enough beds and nurses during busy times, without leaving lots of bed and nurses "waiting around" during quiet times of the year? |
In general, theatre schedules are such that patients whose operations require intensive care facilities post-operatively are managed so there's always a few patients in ICU beds
The ideal base ratio for nurses to patients in ICU is 1:1 (trained nurses, with healthcare assistants on hand with routine lifting, cleaning tasks, etc.) with one extra to manage the unit (if the phone goes for instance, someone experienced needs to be able to answer it)
Sometimes the ratio is higher than that (nurses to patients) but not excessively. There are also HDU beds in most facilities (a kind of half-way house between ICU and a general ward). In addition, ICU staff are required to keep continually updated (even more so than in general) and education/training can take place during quieter times | |
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| Tier 2 / Tier 3 on 13:37 - Oct 19 with 2216 views | tony_roch975 |
| Tier 2 / Tier 3 on 12:37 - Oct 19 by D_Alien |
During quieter times, you can't have large numbers of ICU beds and just as importantly, ICU-trained staff just waiting around for patients to turn up, that'd be a ridiculous waste of resources. And it's not as if they can easily be redeployed since demand can suddenly spike - if there was a major road traffic accident with multiple casualties, for instance
Current capacity (pre-Covid) was carefully balanced to ensure enough was available, although it's constantly under review
[Post edited 19 Oct 2020 12:42]
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Evidently the balance was wrong since we had to spend unplanned millions on Nightingale hospitals, we transferred the virus from hospitals to Care Homes where tens of thousands died and we cut back all non-Covid care so an indeterminate number more suffered and died. Indeed, it is exactly that 'spare' capacity in countries like Germany that gave them an advantage over the UK situation. Rather than 'just waiting around for patients to turn up', wouldn't extra capacity begin to deal with the long-standing waiting lists in non-emergency care and in the provision of far greater preventative care which would benefit millions of our fellow citizens? | |
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| Tier 2 / Tier 3 on 14:07 - Oct 19 with 2164 views | BigDaveMyCock |
| Tier 2 / Tier 3 on 13:17 - Oct 19 by isitme |
NHS England is his source. There is link to the full data set in the embedded tweet above.
Also
[Post edited 19 Oct 2020 13:21]
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Just reading the article in the Guardian and the spokesman for NHS Greater Manchester said he is ‘monitoring the situation and that it’s not unusual for 80-85% of ICU beds to be in use at this time of year’. Given this, I’m not quite sure what Joshi thinks he’s unearthed here.
The problem with the stats is that they only go up to Feb. 2020 so you can’t do a like for like comparison or even factor in the impact of COVID. For example, we don’t know from those stats:
(i) what has been the level of increased capacity in ICU because of COVID - for example, 80% of 4000 beds in October 2019 is not the same as 80% of 8,000 beds in October 2020;
(ii) the number of patients with COVID in ICU. Are patients who would normally be treated in ICU not being (cancelled operations etc.) or being treated on other separate wards; and
(iii) we seem to be at the beginning of an upward curve in respect of admissions. Stats. from March to June of this year would be useful in this regard.
The reason why this isn’t a story is because it may not be a like for like comparison. [Post edited 19 Oct 2020 16:49]
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| Tier 2 / Tier 3 on 14:26 - Oct 19 with 2132 views | TipperaryDale |
| Tier 2 / Tier 3 on 13:25 - Oct 19 by D_Alien |
In general, theatre schedules are such that patients whose operations require intensive care facilities post-operatively are managed so there's always a few patients in ICU beds
The ideal base ratio for nurses to patients in ICU is 1:1 (trained nurses, with healthcare assistants on hand with routine lifting, cleaning tasks, etc.) with one extra to manage the unit (if the phone goes for instance, someone experienced needs to be able to answer it)
Sometimes the ratio is higher than that (nurses to patients) but not excessively. There are also HDU beds in most facilities (a kind of half-way house between ICU and a general ward). In addition, ICU staff are required to keep continually updated (even more so than in general) and education/training can take place during quieter times |
So, operations which should happen during the busy times are postponed to the quieter times, along with education and training. Meaning that when something unforeseen happens (Covid, big emergencies, staff shortages); planned operations and education gets pushed back, pre-op patient suffering gets prolonged, staff are at risk of burnout due to lack of numbers and have to 'catch up' with training later on when things (hopefully) go quieter? Is that the gist of it?
Waste of resources you say? I'd say a few more beds and nurses would not be a bad use of resources myself. Surely the quicker you treat people and the quicker you get people off waiting lists the cheaper it will be in the long run? | | | |
| Tier 2 / Tier 3 on 14:26 - Oct 19 with 2130 views | off2div1 |
What does Andy Burham want now .He has been offered lots of money . What's next on his agenda.  |  | | |
| Tier 2 / Tier 3 on 14:31 - Oct 19 with 2119 views | D_Alien |
| Tier 2 / Tier 3 on 13:37 - Oct 19 by tony_roch975 |
Evidently the balance was wrong since we had to spend unplanned millions on Nightingale hospitals, we transferred the virus from hospitals to Care Homes where tens of thousands died and we cut back all non-Covid care so an indeterminate number more suffered and died. Indeed, it is exactly that 'spare' capacity in countries like Germany that gave them an advantage over the UK situation. Rather than 'just waiting around for patients to turn up', wouldn't extra capacity begin to deal with the long-standing waiting lists in non-emergency care and in the provision of far greater preventative care which would benefit millions of our fellow citizens? |
Evidently, the balance quite simply wasn't wrong pre-Covid
Those patients requiring planned post-operative intensive care (sometimes for just 24 hours) are not the patients who're generally on long-standing waiting lists, but those with severe conditions involving heart & major blood vessel disease, lung, oesophagus, trachea
Those on longer waiting lists such as hip/knee surgery simply wouldn't require an ICU bed (unless something went drastically wrong). And that's a different argument (about the length of waiting lists) but doesn't impact on ICU capacity | |
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| Tier 2 / Tier 3 on 14:47 - Oct 19 with 2092 views | nordenblue |
| Tier 2 / Tier 3 on 14:26 - Oct 19 by off2div1 |
What does Andy Burham want now .He has been offered lots of money . What's next on his agenda. |
I think he's waiting for a knighthood,got a good ring to it Sir Andy Burnham? | | | |
| Tier 2 / Tier 3 on 14:47 - Oct 19 with 2094 views | Shun |
| Tier 2 / Tier 3 on 13:37 - Oct 19 by tony_roch975 |
Evidently the balance was wrong since we had to spend unplanned millions on Nightingale hospitals, we transferred the virus from hospitals to Care Homes where tens of thousands died and we cut back all non-Covid care so an indeterminate number more suffered and died. Indeed, it is exactly that 'spare' capacity in countries like Germany that gave them an advantage over the UK situation. Rather than 'just waiting around for patients to turn up', wouldn't extra capacity begin to deal with the long-standing waiting lists in non-emergency care and in the provision of far greater preventative care which would benefit millions of our fellow citizens? |
I've just tried answering this but then realised DA has done a better job than I managed. He was specifically talking about the balance pre-Covid, and that balance wasn't wrong at all. In fact, it managed very well while delivering high quality care and having some of the most highly trained nursing staff in the trust.
Having hundreds of spare ICU beds unoccupied and a similar amount of ICU nurses with no patients is tremendously expensive. The environments of ICU and wards are so different it's not as if when ICU is quiet they can just be sent to cover on the wards either. |  | | |
| Tier 2 / Tier 3 on 14:57 - Oct 19 with 2067 views | off2div1 |
| Tier 2 / Tier 3 on 14:47 - Oct 19 by nordenblue |
I think he's waiting for a knighthood,got a good ring to it Sir Andy Burnham? |
He's waiting for the Andy Burham hospital but its not got any empty beds. | | | |
| Tier 2 / Tier 3 on 15:33 - Oct 19 with 2006 views | rochdaleriddler |
| Tier 2 / Tier 3 on 14:47 - Oct 19 by nordenblue |
I think he's waiting for a knighthood,got a good ring to it Sir Andy Burnham? |
You don’t get knighthoods/lordships unless you donate to the Tory party, or are related to Boris, or agree with everything the govt does |  |
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| Tier 2 / Tier 3 on 15:39 - Oct 19 with 2000 views | judd |
| Tier 2 / Tier 3 on 15:33 - Oct 19 by rochdaleriddler |
You don’t get knighthoods/lordships unless you donate to the Tory party, or are related to Boris, or agree with everything the govt does |
Who is the leader of the labour party? |  |
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| Tier 2 / Tier 3 on 16:04 - Oct 19 with 1959 views | roccydaleian |
| Tier 2 / Tier 3 on 15:39 - Oct 19 by judd |
Who is the leader of the labour party? |
Lord Kinnock? |  | | |
| Tier 2 / Tier 3 on 16:45 - Oct 19 with 1902 views | rochdaleriddler |
| Tier 2 / Tier 3 on 15:39 - Oct 19 by judd |
Who is the leader of the labour party? |
I meant under the current govt | |
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| Tier 2 / Tier 3 on 20:59 - Oct 19 with 1757 views | mingthemerciless |
| Tier 2 / Tier 3 on 14:47 - Oct 19 by Shun |
I've just tried answering this but then realised DA has done a better job than I managed. He was specifically talking about the balance pre-Covid, and that balance wasn't wrong at all. In fact, it managed very well while delivering high quality care and having some of the most highly trained nursing staff in the trust.
Having hundreds of spare ICU beds unoccupied and a similar amount of ICU nurses with no patients is tremendously expensive. The environments of ICU and wards are so different it's not as if when ICU is quiet they can just be sent to cover on the wards either. |
Do you think it'd be more expensive than the current shambles ? | | | |
| Tier 2 / Tier 3 on 11:00 - Oct 20 with 1527 views | 49thseason |
Excess deaths week 41 ( w/c 9th October)for England and Wales by region.
Table 1: The number of deaths registered was above the five-year average in most of the English regions and Wales
Number of deaths in Wales and the regions in England, registered week ending 9 October 2020
Region name Number of deaths Five-year average Difference Percentage above average
Yorkshire and The Humber 1,067 967 100 10.3
East Midlands 884 824 60 7.3
West Midlands 1,053 985 68 6.9
North East 544 510 34 6.7
Wales 638 615 23 3.7
North West 1,367 1,328 39 2.9
London 902 914 -1 -1.3
South East 1,462 1,505 -43 -2.9
South West 1,010 1,054 -44 -4.2
East 1,019 1,081 -62 -5.7
Source: Office for National Statistics — Deaths registered weekly in England and Wales |  | | |
| Tier 2 / Tier 3 on 11:21 - Oct 20 with 1493 views | D_Alien |
| Tier 2 / Tier 3 on 11:00 - Oct 20 by 49thseason |
Excess deaths week 41 ( w/c 9th October)for England and Wales by region.
Table 1: The number of deaths registered was above the five-year average in most of the English regions and Wales
Number of deaths in Wales and the regions in England, registered week ending 9 October 2020
Region name Number of deaths Five-year average Difference Percentage above average
Yorkshire and The Humber 1,067 967 100 10.3
East Midlands 884 824 60 7.3
West Midlands 1,053 985 68 6.9
North East 544 510 34 6.7
Wales 638 615 23 3.7
North West 1,367 1,328 39 2.9
London 902 914 -1 -1.3
South East 1,462 1,505 -43 -2.9
South West 1,010 1,054 -44 -4.2
East 1,019 1,081 -62 -5.7
Source: Office for National Statistics — Deaths registered weekly in England and Wales |
The five-year average will almost certainly include, in one or more of those years, variations from the average which will be higher/lower than this year's figure due to natural variation
Comparison for the purposes of Covid debate therefore indicates only that there's nothing statistically significant happening in most regions, with the exception perhaps of the top three. The sample size of one week is itself not particularly useful. Variations in weather patterns could easily lead to excess deaths during, for instance, a particularly cold or foggy week at this time of year
[Post edited 20 Oct 2020 11:24]
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| Tier 2 / Tier 3 on 11:26 - Oct 20 with 1485 views | Shun |
| Tier 2 / Tier 3 on 11:21 - Oct 20 by D_Alien |
The five-year average will almost certainly include, in one or more of those years, variations from the average which will be higher/lower than this year's figure due to natural variation
Comparison for the purposes of Covid debate therefore indicates only that there's nothing statistically significant happening in most regions, with the exception perhaps of the top three. The sample size of one week is itself not particularly useful. Variations in weather patterns could easily lead to excess deaths during, for instance, a particularly cold or foggy week at this time of year
[Post edited 20 Oct 2020 11:24]
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Absolutely. It's ludicrous to make comparisons to previous years, especially with a sample size of one week. People abiding to Covid protocol this year means less elderly people out shopping or walking, which means less falls and less deaths. Less cars on the roads means less RTAs. Shorter pub opening times means less alcohol-influenced deaths.
Huge number of variables. | | | |
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