The UK is likely on the brink of a major COVID-19 outbreak. About 6% to 10% of infected people are likely to be critically ill, most of whom will require ventilation support in an intensive care environment.

Italy is already experiencing extreme stress on its intensive care system and in a matter of weeks the UK too may be facing a situation where demand for intensive care exceeds capacity.

The NHS urgently needs to address the question of how access to intensive care is determined when there are not sufficient resources to treat everyone.

The default when demand for services outstrip supply is first-come first-served, where resources are locally allocated on the principle of “next in line” and no one is excluded a priori.

Triage protocols are designed to promote a more rule-based system for allocating scarce resources fairly and transparently, where, by definition, some groups of people are excluded from access to care.

Various protocols for triage to intensive care have been suggested for use in a pandemic.

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