Hospitals in England are declaring critical incidents with radiotherapy machines, MRI scanners, cooling units and IT systems failing owing to the extreme heat.
Here four doctors describe their experiences on the frontline that they say feels unsafe and dangerous for patients amid the worst NHS heatwave crisis in years.
Resident doctor, north-west England
“On Wednesday, I led a ward round on an AMU [acute medical unit]. The office I started from was shared with eight other staff members, and the wall-mounted thermometer read 36C [96.8F]. No spare fan, and certainly no air conditioning, was available.
“Out of seven patients reviewed, four of them had adverse effects due to the extreme heat. These included falls due to postural hypotension, and multiple pre-renal AKIs [acute kidney injuries].
“Almost all received IV fluids to account for insensible losses in a ward lacking in air-conditioning or ventilation. Patients on medications known to cause issues in extreme heat had not been given specific advice on adjusting these during extreme weather and were admitted to hospital as a result.
“The emergency buzzer was then pulled for a seizing patient. Resuscitation was provided in a side room with poor insulation and no air conditioning. Sweat was falling on to the patient from the faces of frustrated staff members, with tempers flaring among colleagues.
“The climate crisis is already happening. It’s clear that the number of admissions due to extreme heat needs to be taken seriously. It increases strain on the physical infrastructure not built to cope, and staff who shouldn’t have to.
“Specialist doctors need to advise appropriately, the NHS needs to plan proactively and hospital departments need to support staff adequately.”
Consultant, Surrey
“This heatwave has pushed patient care into concerning territory. In the heat, corridor care has become more serious and more unsafe.
“We are now ‘reverse parking’ patients opposite one another because there is simply nowhere else to put them. Privacy and dignity disappear instantly. We are breaking bad news in corridors with other patients listening because there’s no room to go anywhere else.
“We are resuscitating patients in corridors after cardiac arrest. This should never happen in a modern health system.
“Bloods are taken, catheters inserted and examinations attempted in spaces that are too cramped to be safe, including for stroke patients who need urgent, careful assessment. Infection control becomes almost impossible.
“The people who suffer most in the heat are the elderly and frail, sadly many of them can spend up to 24 hours in a corridor. Some don’t even have a bed and sit through the night in a chair.
“In some hospitals, there are now five active ‘care corridors’. This heat has made an already dangerous situation even more urgent.”
Resident doctor, London
“I work on a ward for older people in London. This week it has been a real effort to keep our patients safe in the heat. The hospital is doing its best: the curtains are all closed to the sun, they have some portable air conditioning machines but despite this the wards are still unbearably hot.
“It has been difficult to keep our patients hydrated, and we notice that for some older people they really struggle to regulate their body temperature in the way younger people can. It seems to be a pattern that our wards aren’t designed for these temperatures.
“My colleague ended up prescribing intravenous fluids to many people on his ward on Wednesday as even with the best efforts of the staff, his patients could not drink enough, and having the curtains closed during the day can be confusing and worsen delirium for our older patients.
“This week has really brought it home to me: the reason we need to do something about climate change is because it is a health crisis. Ultimately, if we carry on burning fossil fuels it is those most vulnerable in society, like my older patients, who are suffering.”
Consultant, London
“During this heatwave, I have worked in three London hospitals so far, and all of them have been unable to maintain healthy working temperatures.
“Colleagues recorded temperatures of 35C in their office on Wednesday and there is real concern that cooling and even sufficient access to fans for vulnerable patients such as those with dementia and terminal illness, is insufficient.
“A colleague has an end-of-life patient on a ward, currently at 32C, with no access to a fan. Maternity units that are unable to maintain a reasonable temperature for mothers giving birth. On Thursday, our COWS [computers on wheels] stopped working because of the heat.
“There are many simple things that staff and institutions can do to mitigate the impact and advice that we are not adequately giving to the population to reduce the risk. What is coming in terms of future worse heatwaves is also predictable and requires urgent review of resilience.”
