NHS overheating in the UK at its highest rate ever

Round Our Way report coverage in the Evening Standard

June 2023: Round Our Way published a new report examining the impact of climate-induced heatwaves on our NHS, the patients who rely on its services and the staff who work in it.

It found that overheating incidents have doubled at NHS sites including hospital wards and surgeries in the last five years. Climate change driven heatwaves are increasingly leading to cancelled operations, staff shortages and even loss of medicine.

The study (download here) analysed NHS data showing that between April 2021 and March 2022 there were a total of 5,554 instances of overheating at NHS sites - up from 2,980 recorded between 2016 and 2017.

An “overheating incident” is when an occupied ward or a clinical area’s daily maximum temperature exceeds 26°C - and triggers a risk assessment to ensure the safety of vulnerable patients. According to the Heatwave Plan for England, 26°C is the temperature above which some vulnerable groups are physiologically unable to cool themselves efficiently.

Some of the reported impacts include patient distress, failure of essential equipment such as refrigeration, disruption to IT and laboratory services, staff discomfort and degradation or loss of medicine. Other studies have shown increases in GP activity and emergency department use for some conditions likely to be associated with heatwaves, and in ambulance call-out rates.

Sandy Robertson, an Edinburgh-based emergency doctor and co-clinical lead at GreenED, said:

“Excessive temperatures, particularly those surpassing 26°C, pose significant risks to the health and wellbeing of patients and vulnerable individuals. In such conditions, the body's ability to regulate heat becomes compromised, leading to a cascade of potentially dangerous physiological responses. Certain medications, including those for Parkinson’s and MS, can hinder the body's natural ability to regulate temperature or increase sensitivity to heat, amplifying the risks associated with high temperatures. Additionally, some medications can cause dehydration or impair the cardiovascular system, which can further exacerbate the negative effects of heat stress.

"The challenges faced by doctors working in emergency rooms are heightened by a heatwave. Last year, resilience was tested when the scorching temperatures caused a complete shutdown of computer systems at Kings Hospital for three days, severely hampering the team’s ability to provide timely care. The relentless heat places immense strain on our dedicated staff, putting them at risk of heat exhaustion and strokes while they tirelessly attend to patients in need. Despite legal limits on working in hot temperatures, the reality in an emergency department is that our primary focus is always on helping people, regardless of the working conditions.”

In April 2018, Leeds-based Verity Clarke (35), gave birth to a healthy baby son amidst record-breaking temperatures of 28°C (82°F) at Leeds General Infirmary on the warmest April day in nearly 70 years. She was considered a “high risk” pregnancy as she has gestational diabetes and was induced ahead of her due date. Verity recalls:

“As the labour progressed I stood at the window for some fresh air and couldn’t believe it when I saw sunburnt men walking around with no shirts on and people having ice creams in the park - I thought I was having gas and air related hallucinations! The combination of the gas and air plus the heat meant I got extremely dehydrated. My mouth felt like cotton wool and I could barely speak, my husband was by my side offering me sips of water but if I drank water too quickly I would vomit due to the labour pain. I was no longer allowed to stand (which felt the most comfortable position at the time) because I was at risk of fainting.

“The medical team diligently monitored my hydration levels because I couldn’t keep the water down and I was put on a drip and given a cold compress. Even more fans were brought into the room, it got very noisy. Eventually, the heat in the room got so high that they had to consider moving me out but the labour ward was up to capacity with other women giving birth so there was nowhere to go.

“Despite the heatwave hurdle, my birth experience at Leeds General Infirmary was positive and I thank the hospital's commitment to delivering exceptional care, even in the most challenging circumstances.”

A recent study into the 2022 summer heatwave found a fifth of UK hospitals were forced to cancel operations (elective surgery) between 16 to 19 July. Factors contributing to heatwave-related cancellations included staff shortages (35.8% of respondents), unsafe theatre environments (30.3%), and bed shortages (22.1%).

BMA Chief Officer, Dr Latifa Patel said:

“The sharp increase in the number of overheating incidents in hospitals is incredibly concerning and further evidence of the need for urgent investment in health service estates to modernise heating and ventilation systems and ensure vulnerable patients are not at risk. 

 “We need to ensure that the NHS can adapt to the increasing threat of climate change and this must be underpinned by sufficient capital investment to make buildings more energy efficient which will be more cost-effective in the long run and positively impact patients, staff and the environment.”

An estimated 90% of current UK hospitals are at risk - and with heatwaves predicted to become more frequent and intense due to climate change, it is highly likely these incidents at NHS sites will increase, and potentially be more disruptive.

Roger Harding, Director of Round Our Way said:

“NHS staff are doing incredible work in difficult circumstances this summer. Due to climate change, heatwaves are increasing in number and severity. The NHS urgently needs more investment to cope with weather extremes but we also have to tackle climate change to stop this getting worse and worse each year.”

The report, written by Jack Jeffrey, was covered in the media in late June and can be downloaded here.