Guy’s and St Thomas' ‘has enough ventilators’ says A&E consultant

Dr Henderson, who has worked for Guy's and St Thomas' NHS Foundation Trust since 2006 and was elected as president of the Royal College of Emergency Medicine last year, was interviewed by Andrew Marr on BBC One on Sunday morning.

She was instrumental in the remodelling of the Emergency Department at St Thomas' Hospital which was completed in 2018.

Here is a transcript of the interview:

Andrew Marr
Dr Henderson, Chris Hopson, of NHS Providers, has said that the situation facing hospitals at the moment is like a "continuous tsunami" of new cases. Is that how it feels?

Katherine Henderson
Good morning. It's very busy. We're seeing a whole different patient group than we were seeing in our previous-to-pandemic work life. We're seeing a continual stream into London hospitals of patients who have got coronavirus.

Andrew Marr
I don't want to be alarmist but we're also told that in three or four places, London hospitals are now running out of critical care capacity, and that might happen by the weekend.

Katherine Henderson
That's certainly not the experience that I've had at my own hospital. London is very busy. London's got a lot of critical care capacity. We're able to share critical care capacity through networks, but obviously some places get a surge and then they need to make arrangements.

Andrew Marr
Now one of the really big issues we know is the number of staff around the NHS up and down the country who are off sick, because somebody in the household may have something. Is testing actually starting to happen? How many of your staff are off sick, for instance?

Katherine Henderson
At the end of last week, we had six members of staff who were off sick with symptoms, and we had 10 who are self-isolating. So there's no question that we're really keen to get staff testing up and running so that we can get these very key people back to work. We haven't started testing staff particularly, but we're confident that there will be a roll-out of that. But the sooner it happens, the better, obviously, from our point of view.

Andrew Marr
And in terms of the scale, we're told that around the country, up to a quarter of staff in the NHS are off for one reason or another, and you could get most of them back by testing. So this is presumably an absolutely critical issue.

Katherine Henderson
I'm not sure we could necessarily get all of them back through testing immediately. Because if somebody has got symptoms and test positive, they need to self-isolate in the way that everybody has to. But what we're really keen to do obviously is get [back] the members of staff who are off because they're having to self-isolate, because a member of their family has symptoms.

Now we've got staff who are staying in local hotels to the hospital, who've identified that somebody is beginning to feel unwell at home and then they move out really rapidly. That's been helpful and that has worked, but to get people tested so that we could be sure that the index case is negative would be incredibly helpful.

Andrew Marr
And what proportion of the staff are off sick at the moment or off work?

Katherine Henderson
Well people are talking about 20 per cent and all of us have been doing staff plans working on the basis that 10 per cent, 20 per cent, 30 per cent of staff could be off at any one time and adapting rotas to make it possible to staff units.

Andrew Marr
Now we're told that finally huge amounts of personal protection equipment, the masks and the and the gowns, and the gloves are now arriving in hospitals, are you seeing that happening?

Katherine Henderson
We've got good supplies. The supply chain has been a problem, no question. The best thing that's going to happen is there's going to be some new guidance coming out in the next couple of days, which I think will relieve a lot of people's anxieties. We need to make sure that frontline health care workers, social care, GPs all have the appropriate kits that they need to see patients and also as importantly feel confident when they're seeing patients that they are doing the right thing.

Andrew Marr
Because there have been reports of kit having to be reused. That's going to stop, is it?

Katherine Henderson
It would be very unusual to be reusing kit, that is some kit that is reusable, face shields you can wipe down and leave up to dry somewhere that that's appropriate. And then those things can be reused. There is stuff that is reusable, but most things are single use and it'd be unlikely that anyone would have been reusing stuff that they shouldn't be.

Andrew Marr
Have you got enough ventilators yet?

Katherine Henderson
Certainly in my trust, we have got enough ventilators.

Andrew Marr
What about critical care standards? This is another issue that worries people. We've got these huge new hospitals opening – the Nightingale and others – and again there are reports that instead of one to one nursing to somebody very seriously sick, it's going to be one nurse looking after six people. Are critical care standards going to be compromised going ahead?

Katherine Henderson
This is something that would be more appropriate to address to a critical care expert. But at the moment, it's sensible to make plans to make sure that we can ventilate people rather than not ventilate people. And if that involves making sure that our nursing staff are in a ratio that makes sense, that's the right thing to do. It's obviously the right thing to do to make plans around that.

Andrew Marr
And what about all of those people up and down the country who have got quite serious conditions, which would normally require hospitalisation and are wondering what to do?

Katherine Henderson
This is a real area of concern and something that as the Royal College of Emergency Medicine we are worried about. We don't want patients who have got serious illnesses to stay at home when they should be coming into hospital.

We completely understand people's anxieties about coming into hospital. But it would be heartbreaking if somebody's having a heart attack or a stroke, but feels they can't come in.

So we are making arrangements for that to be safe. We're dividing our departments into respiratory areas and non-respiratory areas so that we can keep the patients who are coming in with things that are clearly not related to coronavirus in a safe environment.

However, we're also aware that patients can present in atypical ways so we will be wearing some protective equipment so that we can make sure that those patients and our staff are safe.

Andrew Marr
Finally, can I put you a quote from Chris Whitty, the Government advisor, which isn't entirely reassuring if you listen to it carefully. He says "if everybody sticks to staying in your household unless absolutely essential, this ... will probably be manageable by the NHS". Does that feel a modulated and accurate assessment of the situation?

Katherine Henderson
I think that's an incredibly serious point. Unless people do stay home, we won't be able to save as many lives as we should. We actually really need people to listen to the Government message on this. It's heartbreaking if people think that because they're young and fit and healthy, they can congregate. But they don't know who their friends may be in contact with – [for example] an elderly relative – and if they give them the coronavirus, they will suffer much more than a young person might. So stay home, save lives. It's a standard message. We've got to get people to do it.

Andrew Marr
Dr Henderson, the next few weeks are going to be absolutely critical. Can I wish you all the very best and thanks for joining us.