'We're coping - but it's precarious'

ICU nurse Jen Aldred says

The peak of demand for NHS trusts in London and the South East may have passed, but hospitals in the East Midlands fear the worst for them may still be to come.

At the Sherwood Forest Hospitals Trust in Nottinghamshire, they are braced for yet more pressure and believe they could be weeks away from seeing a peak in Covid patient numbers.

"We know that our hospitals are incredibly busy at the moment," says Richard Mitchell, chief executive of the trust.

"And the rate of Covid continues to be out of control in the community."

He said about 60% of the cases being picked up in the community were the new variant.

King's Mill Hospital at Sutton-in-Ashfield near Mansfield - one of the hospitals within the trust - has more than 200 Covid patients, more than double the number at the peak last April.

Altogether, around 1,000 people with Covid have been treated and recovered there since the since the start of the pandemic.

The hospital doesn't have the scale or resources of a major London teaching hospital so the burden is, relatively speaking, greater.

And they are caring for some low income communities, where health inequalities are all too obvious.

Dr David Selwyn, the trust's medical director, says: "We are in an old mining town in the north of Nottinghamshire. We have a lot of deprivation. We have a lot of smoking related disease and history from the mining industry". So people have underlying health care issues associated with that, and we've seen that impact.

"One of the real lessons we need to take out about this is how we get health care messages into these hard to reach areas".

He says using the right language to serve diverse communities should be a priority.

'One of the worst shifts'

As in other areas, there's a mutual support system in the East Midlands with hospitals taking on patients from others which may be overstretched.

Dr Som Sarkar is the clinical leader for critical care at Sherwood Forest Hospitals says the hospital is at a stage where "the provision of safe services may be compromised".

Patients sometimes have to be transferred further afield, something that rarely happens in non-pandemic times and which adds a significant burden - not least for families whose loved ones may be treated hundreds of miles away.

Dr Sarkar says they "continue to cope but it is very precarious."

Intensive care is also stretched - the hospital has had to triple the number of beds.

Dr Som Sarkar says the trust is having to send patients hundreds of miles away for treatment

Jen Aldred, who has been a nurse for 21 years, who's been redeployed to ICU, says the shifts in recent weeks have been "the toughest I have ever had".

"One of the night shifts last week was one of the worst. It was really sad the patients that died, the family members who couldn't be here."

The national data shows case numbers are falling. But in the Mansfield area there is more of a plateau than the clear decline seen in London and the South East.

Prof Chris Whitty, the UK Government's Chief Medical Adviser, said at a recent media briefing that hospital numbers are beginning to flatten out, with a reduction in London.

But at King's Mill Hospital they are braced for an even harder couple of weeks.

Staff are tired and wonder when this latest surge will ebb. Richard Mitchell says the trust is doing everything it can to support people.

"There's no point having beds without staff - the NHS has been under huge pressure now for 11 months so people are worn out.

"We do need to recognise that people have been living with Covid in their personal and working lives for an exceptionally long time."