Health service bosses are optimistic the peak of the pandemic's second wave in hospitals may have passed - but warn pressure on intensive care remains as high as ever.

The number of patients in Maidstone and Tunbridge Wells hospitals with Covid-19 is now declining from "battlefield" levels seen in recent weeks, but there remains a note of caution that although numbers appear to be trending downwards the demand for beds may plateau rather than drop sharply.

This morning a board meeting of the Maidstone and Tunbridge Wells NHS Trust heard how critical care remains in a state of "super surge" as unprecedented demand for intensive care for the very worst cases of coronavirus draws medical staff from other areas of the health service locally.

Addressing the meeting held online earlier, the Trust's chief executive Miles Scott said: "Since the last board meeting we have hit this extraordinary peak of Covid activity, three and a half times the first wave peak.

"I think it is important that the board understands that it does feel like we have now passed that peak, both in terms of numbers of patients - we have got about 100 fewer patients now in beds in our hospitals with Covid than we had at new year and that number keeps reducing by a small number each day - and we have also passed the peak in terms of staffing absence.

"It is those two things compounded together that made such an extraordinary pressure for us.

"But we need to be clear we are still at twice the first-wave peak, and we should be particularly conscious of the fact critical care is still at its peak and our critical care capacity has gone beyond what was planned as 'surge', into what we are technically calling 'super surge'.

"And that's really important because that is very resource-intensive work, it clearly has a huge emotional and professional toll on people, and it also means that a lot of our staff who would normally be working in other areas, particularly other surgical areas, are actually committed to critical care. We need to remember that those numbers are not going down yet."

At the peak of the second wave, there were 334 people in hospital with Covid-19. That number has since fallen, but the latest figures show 21 people were still requiring critical care with the support of ventilation.

Mr Scott also provided an update on the pressures facing the South East Coast Ambulance Service (Secamb), which he said was still busy despite a reduction in the numbers of ambulances arriving at the Trust's hospitals.

He said could by the end of the week Secamb would be in a position to "de-escalate" and begin providing cover for other services such as home births.

"We are now beginning to turn our attention to resetting and de-escalating the organisation," Mr Scott told the board.

"I think the thing that I really want to emphasise about that is that because the peak was so much higher than the first-wave peak we have to take very much a quality-led approach to that de-escalation.

"In particular we are very focused on ensuring we recover normal and sustainable standards of patient care. We have been having to provide a kind of battlefield medicine, and we need to get back to what we want to be delivering and then building our services out from there.

"We are going to have to be patient, I think, about the restoration of elective work but we are anxious to get on with that as soon as we can."

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