Bedfordshire and Milton Keynes hospital and ambulance services feeling the pressure
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"We're seeing a significant further spike of Covid from a variant of the Omicron virus," BLMK Clinical Commissioning Group accountable officer Felicity Cox warned its governing body on March 29.
"The peak is higher than that in January and we're getting a significant backlog in that service. We needed to ensure our clinicians could support it.
"Mostly it's in relation to exacerbations of other diseases and not necessarily entirely driven by Covid, but with it as a compounding factor.
"We've more seriously ill people unvaccinated or partially vaccinated in hospital as well, so we continue to urge people to get their vaccines."
BLMK director of performance and governance Geraint Davies said: "There are two key pressure points. One is an increase in what we call normal accident and emergency activity.
"We're also seeing rising case rates and growing Covid activity within our hospitals. Our key performance risk is our urgent care system.
"There's the handovers between hospitals and ambulance service, and throughput at the hospital along with discharges into the community. So we're looking at the pathway of care and treatment through those various stages.
"On March 22nd, we had 239 patients who were diagnosed with Covid in our hospitals. That was an increase on previous weeks. But by March 28th, that had risen to 260, so the numbers are going up in terms of in-patients.
"We're not seeing corresponding pressure on the intensive therapy units with patients requiring mechanical ventilation or otherwise. They're still in the low numbers, so ones and twos.
"The key risk to us is the growing pressure from the number of patients in the hospitals," he added. "The number of Covid patients is about 15 to 17 per cent of the bed stock, which is a major pressure for us.
"Also linked to that we're seeing an increase in the number of patients not being discharged from hospital.
"So the length of stay of individuals of 21 days and above has risen by five from 113 to 118 in that same period."
The key clinical risk the NHS is facing currently is patients with the ambulance service are unable to attend where it cannot send a vehicle to them, according to Mr Davies.
"Handover delays are increasing across all of our acute sector," he explained. "Our mean response time around the ambulance service in our operational area is increasing above required standards.
"We're seeing major delays for our population and that's leading to major clinical risk which we need to address. We're developing a plan which needs to be submitted by April 1st.
"We're working with the sub-system for Bedford and Luton and that for Milton Keynes, along with the two ambulance trusts."
CCG lay member for audit and governance Saqhib Ali said: "So for nearly seven years the East of England Ambulance Service has regularly been on the list.
"We've had new chief executive officers, we've had deep dives, we've had working together as we've been told 'we're part of a consortium' and there've been different explanations. Can the two ambulance services learn from each other?"
Mr Davies replied: "All the English ambulance services are experiencing similar levels of pressure, so it's not unique to East of England.
"They're all at similar levels of activity pressure through demand from non-Covid and Covid activity.
"We're bringing together the operation managers from East of England and South Central in a collective forum across BLMK."