Coronavirus UK: NHS hospitals treating MORE patients than in spring

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Two thirds of hospitals presently have extra Covid sufferers than they did on England’s worst day in April final 12 months when the pandemic first exploded, official figures present as Quantity 10 final evening shifted again to a different nationwide lockdown to ‘defend the NHS’.

There have been a document 26,000 contaminated sufferers in hospital beds throughout England on January 2, the newest day information is obtainable for, and medical doctors warn admissions are nonetheless accelerating because the second wave rages on.  

Boris Johnson final evening introduced the hardest lockdown since spring amid fears the resurgence of the virus, pushed by a super-infectious new variant, will trigger hospitals to be overwhelmed by the virus inside weeks. 

London yesterday reported 828 new coronavirus sufferers have been admitted to hospital on January 2, within the highest every day toll for 9 months and near the document of 883 again in March.

And evaluation of official statistics reveals some hospitals in hard-hit areas similar to Kent and East Sussex are seeing as much as 3 times as many coronavirus sufferers as they did on April 12, the purpose of the primary wave at which affected person numbers have been highest.

NHS workers from throughout the nation say caring for surging numbers of individuals is turning into increasingly more troublesome, with one London hospital final week declaring it was in ‘catastrophe’ mode. One physician stated medics in some badly hit areas are already having to determine methods to ration ventilators for intensive care sufferers and face ‘horrifying’ selections at work.

Chief of healthcare union NHS Suppliers, Chris Hopson, stated the spike in Covid inpatients since Christmas alone was sufficient to fill 18 hospitals. And the Royal Faculty of Surgeons’s president, Professor Neil Mortensen, warned that affected person numbers are actually so excessive that most cancers operations could should be sidelined once more. There was chaos in spring when non-urgent ops have been cancelled and the NHS is now preventing its method via a backlog of 1000’s.

NHS England statistics present that, in the newest information from December 29, 81 out of 127 main hospital trusts had extra Covid sufferers than on April 12.

Lots of the worst affected are within the South East and London, the place the brand new fast-spreading variant of the virus has taken maintain, with these areas now making up a majority of the every day constructive checks being reported.

Hospitals within the North West, which endured the total pressure of the second wave earlier within the autumn, have now seen affected person numbers drop to extra manageable ranges. The brand new pressure of the virus just isn’t but spreading as extensively within the North of the nation. 

Graph shows the NHS hospital trusts that have the highest number of Covid-19 patients now compared to in April, with many hospitals seeing three or even four times as many people with the disease than they did at the height of the first wave

Graph reveals the NHS hospital trusts which have the very best variety of Covid-19 sufferers now in comparison with in April, with many hospitals seeing three and even 4 instances as many individuals with the illness than they did on the top of the primary wave

Mr Hopson stated final evening that there was ‘one other steep rise within the variety of Covid circumstances, and the variety of sufferers being admitted to hospital can be rising at an alarming price. 

‘There are nearly 9,000 extra Covid sufferers in hospital beds – the equal of practically 18 hospitals – than there was on Christmas Day, simply 10 days in the past. 

‘We all know that quantity goes to proceed to rise over the following few weeks. The lockdown announcement will assist, however provided that everybody follows the principles.’

WHICH HOSPITALS HAVE SIGNIFICANTLY MORE PATIENTS THAN IN THE SPRING?

Nearly two thirds of hospitals in England had extra Covid-19 sufferers on the finish of December than they did on April 12, which was the worst day for England as an entire in the course of the first wave.

The worst-affected hospitals now are largely within the South of England, however NHS trusts within the North skilled related spikes in sufferers initially of the second wave within the autumn.

Hospital trusts listed beneath had the largest distinction between complete affected person numbers in April and December, measured in uncooked numbers not adjusted for hospital measurement.

Covid sufferers on April 12, 2020 

Covid sufferers on Dec 29, 2020

Mid/South Essex

East Kent 

Maidstone

Portsmouth 

East Sussex

Barking, Havering

Frimley Well being 

North Midlands

Dartford

Hull College

374

143  

85

130

68

171

276

134

79

44

785

415

299

342

257

356

453

304

241

191

NHS figures present that on the worst day within the first wave, April 12, there have been 18,974 folks with Covid-19 in England’s hospitals.

On December 29 this was 21,787. It has since spiralled to 26,626 however hospital-by-hospital information just isn’t but obtainable for the additional 5,000 sufferers.

December’s information reveals that London has the best variety of Covid sufferers in hospital – partially as a result of it has the largest inhabitants – however there have been far sharper rises within the South East and the East of England.

Within the East of the nation, inpatient numbers are 74 per cent larger than they have been within the spring, with 2,922 sufferers on December 29 in comparison with 1,679 on April 12.

There have been 62 per cent extra within the South East – 3,796 in comparison with 2,342.

In London, the Midlands and the South West, there have been between eight and 9 per cent extra sufferers on the finish of December than on the nation’s peak in April.

However the North East, North West and Yorkshire all now have fewer inpatients than they did 9 months in the past. 

Many hospitals within the North, nonetheless, skilled the identical spiralling pressures now being seen within the South initially of the primary wave in September, October and November, when circumstances have been nonetheless low in different elements of the nation.

Mid and South Essex NHS belief, which runs hospitals in Southend, Basildon and Chelmsford, is among the ones to have seen the largest spike in sufferers in the course of the second wave. On December 29 it had 785 folks on wards with Covid-19, which was 411 greater than double the 374 on April 12, England’s peak.

East Kent Hospitals has seen admissions nearly 3 times as excessive, with 415 sufferers in comparison with 143, whereas the Maidstone and Tunbridge Wells belief had 3.5 instances as many sufferers in December: 299 in comparison with 85. 

The UK’s chief medical officers warned final evening that there’s a threat the well being service may very well be overwhelmed inside weeks as they upgraded the coronavirus threat stage to the utmost stage 5.

In a letter written by the UK’s 4 CMOs – who embrace Professor Chris Whitty – and NHS England’s nationwide medical director, Professor Stephen Powis stated: ‘Following recommendation from the Joint Biosecurity Centre and within the mild of the newest information, the 4 UK chief medical officers and NHS England medical director advocate that the UK alert stage ought to transfer from Degree 4 to Degree 5.

‘Many elements of the well being techniques within the 4 nations are already underneath immense strain. There are presently very excessive charges of neighborhood transmission, with substantial numbers of Covid sufferers in hospitals and in intensive care.

‘Circumstances are rising nearly all over the place, in a lot of the nation pushed by the brand new extra transmissible variant. We’re not assured that the NHS can deal with an additional sustained rise in circumstances and with out additional motion there’s a materials threat of the NHS in a number of areas being overwhelmed over the following 21 days.

‘Though the NHS is underneath immense strain, vital adjustments have been made so folks can nonetheless obtain lifesaving therapy.

‘It’s completely crucial that individuals nonetheless come ahead for emergency care. If you happen to require non-urgent medical consideration, please contact your GP or name NHS 111.’

 

Surgeons have warned that the rising numbers of sufferers being seen throughout the nation may imply that most cancers operations fall by the wayside once more.

Document variety of sick sufferers are ready 12 hours on a stretcher

NHS figures yesterday revealed a document variety of very sick sufferers waited on trolleys in A&E throughout December.

The info, seen by the Health Service Journal, reveals that greater than 2,930 folks spent no less than 12 hours in A&E departments.

Practically half of those have been in London.

The earlier highest variety of 12-hour trolley waits – the time between arriving at A&E and receiving a mattress – was 2,847 in January 2020.

The provisional figures – which is able to most likely improve -are set to be printed formally by NHS England subsequent week. 

Vice chairman of the Royal Faculty of Emergency Drugs Adrian Boyle informed The Times: ‘Nobody must spend 12 hours in an emergency division. 

‘Not solely is it undignified for sufferers, however research have discovered that the longer a affected person waits for admission to a hospital mattress, the larger the chance of demise.’

He added: ‘These waits normally end result from an absence of inpatient beds and workers, and — in addition to placing the affected person in danger — result in additional harmful crowding and hall care inside the emergency division. 

He stated the extra sufferers there are on stretchers, the tougher it’s to manage care in an already-strained A&E.

Docs have been already making an attempt to make their method via a backlog of tens of millions of non-Covid sufferers earlier than the second wave struck, and this progress is now threatened once more regardless of officers saying cancelling routine operations once more could be unthinkable.

The primary operations to be postponed are non-urgent ones for situations that are not life-threatening, similar to joint replacements and cataracts. Extra severe procedures similar to organ surgical procedures or most cancers operations are stored going for longer till well being bosses don’t have any alternative however to cancel them as a result of an absence of workers or restoration beds.

Professor Neil Mortensen, president of the Royal Faculty of Surgeons, warned the scenario in hospitals is getting ‘a lot worse’, and escalating quicker than the ‘slow-motion automobile crash’ he beforehand predicted.

King’s Faculty Hospital in south London has already known as off all ‘precedence 2’ most cancers operations, procedures which specialists have judged to be pressing and should be achieved inside 28 days of a choice to undertake them.

It’s feared different hospitals within the nation could face the identical troublesome resolution within the coming days if admissions do not begin to fall.

Professor Mortensen informed Instances Radio: ‘My colleagues in London doing ward rounds, for instance, report that there are issues with workers numbers on the wards, workers numbers in theatres.

‘After which after all if you’ll want to go to the intensive care unit, if the intensive care unit is stuffed with Covid sufferers there is no room for you.

‘So it is a actually severe scenario and, clearly, the less-priority operations have already stopped in lots of locations – hips, knees, ENT (ear nostril and throat) procedures.

‘We’re now involved about operations like most cancers surgical procedures being cancelled or postponed as a result of there simply is not the capability to have the ability to handle them.’

He added: ‘I believe if in case you have a delayed operation for most cancers which will have an impact.

‘If you happen to are available from a highway site visitors accident and also you’re critically sick, and you’ll want to go to an intensive care unit afterwards and there’s no intensive care unit, that is going to have severe penalties.

‘And that is why everyone is so involved proper now that we’re correctly locked down, that we’re so far as we presumably can decreasing the transmission of the virus, and making it doable for what amenities we do have to hold on working successfully to maintain folks alive.’

‘Important incident’ declared at Lincoln County Hospital as Covid affected person numbers rise 

Well being bosses have declared a ‘crucial incident’ at Lincoln County Hospital over rising numbers of Covid-19 sufferers.

There round 200 sufferers with Covid-19 within the hospital in Greetwell Street and at Pilgrim Hospital in Boston at a time of workers shortages due to an infection and self-isolation.

The suspension of affected person visiting in all however distinctive circumstances continues. The crucial incident – the very best alert stage – means most nose to nose workers coaching stays cancelled, however important core studying, research depart and annual depart can proceed.

The Grantham & District Hospital ‘inexperienced web site’ stays totally operational, finishing up pressing and most cancers surgical procedure for folks from throughout Lincolnshire.

United Lincolnshire Hospitals NHS Belief deputy chief government Mark Brassington stated: ‘We declared a crucial incident final evening, Monday, January 4 at Lincoln County Hospital as a result of massive variety of sufferers requiring admission.

‘We’re sorry for the waits that our sufferers have confronted yesterday and in a single day. The incident is being managed internally with help from our companions and sufferers ought to proceed to attend appointments until contacted immediately.’

He added: ‘The variety of inpatients who’ve been confirmed as having COVID-19 throughout our websites stays larger than in wave one and we stay extraordinarily busy throughout our wards and intensive care items.

‘Our place is compounded by challenges with staffing as a result of an absence of availability of colleagues as a result of a lot of elements.

‘We want to thank all of our colleagues for all they’re doing to help one another and for persevering with to take care of sufferers throughout these troublesome instances.

‘The general public will help by making certain they observe authorities tips to cut back the unfold of Covid-19 and by making certain they use probably the most applicable NHS service for his or her situation.’

The best stage of alert was beforehand declared at Lincoln County Hospital and Pilgrim Hospital, Boston in November when the variety of sufferers with Covid-19 at each hospitals rose from 56 to 175 in per week at a time of workers shortages.

Coaching, research depart, non-clinical time, and, the place doable, annual depart, have been cancelled.

 

IS YOUR HOSPITAL BUSIER NOW THAN IT WAS IN THE FIRST WAVE OF CORONAVIRUS LAST YEAR? (NHS England information) 
NHS Belief identify Covid-19 sufferers on
April 12, 2020
Covid-19 sufferers on
 December 29, 2020
Distinction (+/-) % distinction
MID AND SOUTH ESSEX NHS FOUNDATION TRUST 374 785 411 110%
EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST 143 415 272 190%
MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST 85 299 214 252%
PORTSMOUTH HOSPITALS NHS TRUST 130 342 212 163%
EAST SUSSEX HEALTHCARE NHS TRUST 68 257 189 278%
BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST 171 356 185 108%
FRIMLEY HEALTH NHS FOUNDATION TRUST 276 453 177 64%
UNIVERSITY HOSPITALS OF NORTH MIDLANDS NHS TRUST 134 304 170 127%
DARTFORD AND GRAVESHAM NHS TRUST 79 241 162 205%
HULL UNIVERSITY TEACHING HOSPITALS NHS TRUST 44 191 147 334%
MEDWAY NHS FOUNDATION TRUST 106 253 147 139%
EAST SUFFOLK AND NORTH ESSEX NHS FOUNDATION TRUST 123 264 141 115%
WEST HERTFORDSHIRE HOSPITALS NHS TRUST 129 270 141 109%
UNITED LINCOLNSHIRE HOSPITALS NHS TRUST 72 201 129 179%
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST 195 304 109 56%
THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, NHS FOUNDATION TRUST 51 159 108 212%
MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 66 171 105 159%
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 73 166 93 127%
NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 77 168 91 118%
WEST SUFFOLK NHS FOUNDATION TRUST 36 126 90 250%
BARTS HEALTH NHS TRUST 559 638 79 14%
NORTHAMPTON GENERAL HOSPITAL NHS TRUST 104 181 77 74%
UNIVERSITY HOSPITALS OF DERBY AND BURTON NHS FOUNDATION TRUST 225 302 77 34%
NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST 210 283 73 35%
NORTH WEST ANGLIA NHS FOUNDATION TRUST 78 150 72 92%
UNIVERSITY HOSPITALS BRISTOL AND WESTON NHS FOUNDATION TRUST 81 150 69 85%
LEWISHAM AND GREENWICH NHS TRUST 286 346 60 21%
BEDFORDSHIRE HOSPITALS NHS FOUNDATION TRUST 180 239 59 33%
HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 90 149 59 66%
GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST 148 207 59 40%
SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST 53 111 58 109%
NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST 226 283 57 25%
EAST LANCASHIRE HOSPITALS NHS TRUST 122 179 57 47%
DONCASTER AND BASSETLAW TEACHING HOSPITALS NHS FOUNDATION TRUST 67 121 54 81%
YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST 14 66 52 371%
COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST 120 170 50 42%
EAST AND NORTH HERTFORDSHIRE NHS TRUST 65 112 47 72%
NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST 70 114 44 63%
BARNSLEY HOSPITAL NHS FOUNDATION TRUST 63 106 43 68%
OXFORD UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 125 167 42 34%
KINGSTON HOSPITAL NHS FOUNDATION TRUST 101 142 41 41%
THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST 109 147 38 35%
CROYDON HEALTH SERVICES NHS TRUST 153 191 38 25%
WHITTINGTON HEALTH NHS TRUST 83 121 38 46%
EPSOM AND ST HELIER UNIVERSITY HOSPITALS NHS TRUST 148 185 37 25%
BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST 107 141 34 32%
SOUTH TYNESIDE AND SUNDERLAND NHS FOUNDATION TRUST 200 231 31 16%
ST GEORGE’S UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 219 249 30 14%
THE ROTHERHAM NHS FOUNDATION TRUST 70 100 30 43%
EAST CHESHIRE NHS TRUST 57 87 30 53%
LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST 132 162 30 23%
ROYAL BERKSHIRE NHS FOUNDATION TRUST 142 169 27 19%
ROYAL DEVON AND EXETER NHS FOUNDATION TRUST 54 81 27 50%
THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST 102 128 26 25%
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 129 155 26 20%
SURREY AND SUSSEX HEALTHCARE NHS TRUST 128 152 24 19%
UNIVERSITY HOSPITALS DORSET NHS FOUNDATION TRUST 76 99 23 30%
SOMERSET NHS FOUNDATION TRUST 32 55 23 72%
ASHFORD AND ST PETER’S HOSPITALS NHS FOUNDATION TRUST 114 136 22 19%
WYE VALLEY NHS TRUST 31 51 20 65%
WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST 77 96 19 25%
WARRINGTON AND HALTON TEACHING HOSPITALS NHS FOUNDATION TRUST 98 112 14 14%
NORTHERN DEVON HEALTHCARE NHS TRUST 15 28 13 87%
BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST 117 129 12 10%
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST 261 272 11 4%
WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST 93 104 11 12%
BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST 88 97 9 10%
SALISBURY NHS FOUNDATION TRUST 38 47 9 24%
SALFORD ROYAL NHS FOUNDATION TRUST 136 144 8 6%
THE DUDLEY GROUP NHS FOUNDATION TRUST 122 129 7 6%
SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 75 81 6 8%
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 142 148 6 4%
GEORGE ELIOT HOSPITAL NHS TRUST 69 75 6 9%
BIRMINGHAM WOMEN’S AND CHILDREN’S NHS FOUNDATION TRUST 5 11 6 120%
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST 130 136 6 5%
ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST 43 48 5 12%
GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST 64 69 5 8%
KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST 69 73 4 6%
ISLE OF WIGHT NHS TRUST 19 23 4 21%
CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST 243 244 1 0%
BUCKINGHAMSHIRE HEALTHCARE NHS TRUST 86 87 1 1%
SHEFFIELD CHILDREN’S NHS FOUNDATION TRUST 1 0 -1 -100%
DORSET COUNTY HOSPITAL NHS FOUNDATION TRUST 17 16 -1 -6%
WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 128 125 -3 -2%
MID YORKSHIRE HOSPITALS NHS TRUST 165 161 -4 -2%
ROYAL CORNWALL HOSPITALS NHS TRUST 32 27 -5 -16%
ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST 63 55 -8 -13%
SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 77 68 -9 -12%
ROYAL FREE LONDON NHS FOUNDATION TRUST 410 400 -10 -2%
TORBAY AND SOUTH DEVON NHS FOUNDATION TRUST 23 13 -10 -43%
ALDER HEY CHILDREN’S NHS FOUNDATION TRUST 11 0 -11 -100%
CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST 65 52 -13 -20%
YORK TEACHING HOSPITAL NHS FOUNDATION TRUST 108 94 -14 -13%
TAMESIDE AND GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST 74 58 -16 -22%
HARROGATE AND DISTRICT NHS FOUNDATION TRUST 34 12 -22 -65%
CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST 93 71 -22 -24%
JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 74 50 -24 -32%
UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST 160 133 -27 -17%
STOCKPORT NHS FOUNDATION TRUST 117 90 -27 -23%
SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 214 186 -28 -13%
NORTH BRISTOL NHS TRUST 107 77 -30 -28%
AIREDALE NHS FOUNDATION TRUST 58 26 -32 -55%
CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 122 87 -35 -29%
KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST 509 474 -35 -7%
GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST 303 267 -36 -12%
HAMPSHIRE HOSPITALS NHS FOUNDATION TRUST 139 103 -36 -26%
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 145 102 -43 -30%
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST 104 59 -45 -43%
BOLTON NHS FOUNDATION TRUST 141 95 -46 -33%
LONDON NORTH WEST UNIVERSITY HEALTHCARE NHS TRUST 357 310 -47 -13%
NORTH CUMBRIA INTEGRATED CARE NHS FOUNDATION TRUST 152 103 -49 -32%
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 134 84 -50 -37%
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST 128 78 -50 -39%
UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST 166 110 -56 -34%
UNIVERSITY HOSPITALS PLYMOUTH NHS TRUST 89 28 -61 -69%
PENNINE ACUTE HOSPITALS NHS TRUST 259 193 -66 -25%
THE ROYAL WOLVERHAMPTON NHS TRUST 228 154 -74 -32%
GATESHEAD HEALTH NHS FOUNDATION TRUST 114 39 -75 -66%
IMPERIAL COLLEGE HEALTHCARE NHS TRUST 334 256 -78 -23%
LEEDS TEACHING HOSPITALS NHS TRUST 230 148 -82 -36%
MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST 85 -85 -100%
WALSALL HEALTHCARE NHS TRUST 180 94 -86 -48%
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 141 53 -88 -62%
ST HELENS AND KNOWSLEY TEACHING HOSPITALS NHS TRUST 153 51 -102 -67%
MANCHESTER UNIVERSITY NHS FOUNDATION TRUST 414 270 -144 -35%
LIVERPOOL UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 346 179 -167 -48%
UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 694 509 -185 -27%



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