Recovery and Restitution of Critical Care Services during the COVID-19 Pandemic

Pressure on UK ICUs due to the COVID-19 pandemic will continue for many months to come, even as the vaccine reduces transmission rates. A slow recovery phase from the winter 2020-21 wave of infections will be complex and dependent on CRITCON status, staffing support and other operational pressures. Sustained use of surge capacity is likely, and will impede recovery by impacting staffing and operational processes. This document provides a list of principles and recommendations for the recovery phase for ICUs.

This document will cover 4 key areas:

1. General Principles of a Critical Care Recovery Plan with a focus on: Space and services, Staffing, Specialist Equipment and impact on Scheduled Surgery.
2. A description of the Critical Care recovery phases and definitions. The timeline for this will be unknown at this time but likely to be many months and potentially years (or at least a more significant increase in activity during Winter months than previous years).
3. Criteria and recommendations for each of the described recovery phases. This is not exhaustive but meant as a toolkit to help support trusts transition ICUs back to occupancy relative to baseline of 80-100% whilst balancing the inevitable tensions of increasing productivity in other specialist areas such as planned surgery.
4. Data showing the scale of additional ICU beds opened in January 2021 compared with January 2020. This is compared regionally. It is crucial when reviewing this data to understand that regions will have experienced peak demands at different times and therefore further analysis will be needed for bed capacity and workforce modelling in the future.