Capacity Transfers Joint Position Statement
In collaboration with the Faculty of Intensive Care Medicine (FICM) we have published our joint position statement on capacity transfers of critically ill patients.
Planned surgery capacity transfers are not a sustainable alternative to an appropriate increase in adequately funded and fully staffed intensive care (level 2 and 3) and enhanced care (level 1) beds. However, over the past two years, transfers have been an essential part of our ability to manage COVID patients.
Our statement aims to ensure that where capacity transfers are performed, it is done in the safest manner possible and after all other alternatives have been considered at local, regional and national levels.
This temporary solution cannot become a part of our working practice long term.
NHS England are also getting ready to release further guidance shortly on which both the Faculty and Society have been consulted.
Intensive care capacity transfers occur because of insufficient staffed beds. They are a temporary measure, attempting to ensure equitable access across the wide range of conditions that require intensive care.
Capacity transfers involve moving a patient to another hospital to enable another patient to receive critical care. They occur for two reasons:
- Emergency capacity transfer- used for many years to deal with surge demand to enable the provision of emergency medical and surgical care (e.g.priority 1a procedure; to be performed in <24 hours). The Intensive Care Society and Faculty of Intensive Care Medicine continue to support this position.
- Planned surgery capacity transfer – used to enable a post-operative critical care bed to become available for another patient (priority 1b procedure; to be performed in <72 hours and priority 2 procedure; to be performed within 1 month). This has been introduced, through necessity, within some regions during the COVID-19 pandemic
The Intensive Care Society and Faculty of Intensive Care Medicine believe that planned surgery capacity transfers are not a sustainable alternative to an appropriate increase in adequately funded and staffed critical care (Level 2 and 3) and enhanced care (Level 1) beds.
The Intensive Care Society and Faculty of Intensive Care Medicine support capacity transfers for planned surgery only when:
- They are needed due to exceptional circumstances requiring a national or health board ‘command and control’ level response e.g. during the COVID-19 pandemic
- There is a serious risk of increased morbidity or reduced survival if surgery was to be delayed.
- There are operational and governance safeguards in place, detailed below.