NHS Nightingale

[Amarillo]

The new NHS Nightingale, now being fitted out inside the EXCEL centre, will have two morgues, and up to 4,000 beds. It will have a waiting area for up to 300 ambulances. Doctors and nurses staffing the hospital will be asked to live on or around the site, away from their families, for several weeks. I don't know where, but as the University of East London accommodation block is just along the road, I expect many will be billeted there - it has all the necessary catering facilities.

The other side of the dock is London City Airport, now requisitioned by the military. Is this to be used to fly patients in from across the country? I know that at least two other field hospitals are likely to be set up in England (Birmingham and Manchester) and one in Scotland.

I'm struggling to get my head around the scale of this new field hospital.

 

[WelshGas]

The new NHS Nightingale, now being fitted out inside the EXCEL centre, will have two morgues, and up to 4,000 beds. It will have a waiting area for up to 300 ambulances. Doctors and nurses staffing the hospital will be asked to live on or around the site, away from their families, for several weeks. I don't know where, but as the University of East London accommodation block is just along the road, I expect many will be billeted there - it has all the necessary catering facilities.

The other side of the dock is London City Airport, now requisitioned by the military. Is this to be used to fly patients in from across the country? I know that at least two other field hospitals are likely to be set up in England (Birmingham and Manchester) and one in Scotland.

I'm struggling to get my head around the scale of this new field hospital.

And one in Wales.

Principality Stadium to become NHS Wales field hospital - Evening Express

Wales’ Principality Stadium is to be converted into a temporary hospital providing around 2,000 additional beds to support the NHS.

www.eveningexpress.co.uk

 

[Amarillo]

And one in Wales.

Principality Stadium to become NHS Wales field hospital - Evening Express

Wales’ Principality Stadium is to be converted into a temporary hospital providing around 2,000 additional beds to support the NHS.

www.eveningexpress.co.uk

I think I remember you saying that one ICU nurse and two nurses could manage two ICU beds. The plan in these field hospitals is a ratio of 1 specialist ICU nurse - supported by other "staff" - per SIX beds.

Also to be decided is if these field hospitals are to run along military lines: "you accept that you cannot do everything for everyone and target treatment on those most able to survive and with a maximum quality of life" or NHS lines: "continue business as usual, and assume resources are infinite".

Revealed: The challenges and dilemmas as NHS Nightingale prepares to open

The NHS and Army's project to convert London's ExCel into a 4,000-bed field hospital - a plan of unprecedented scale for this country - is grappling with major clinical and cultural tensions, as well as the huge logistical challenge, ahead of its official opening next week.

www.hsj.co.uk

 

[Maxx]

4000 bed capacity is a behemoth of a hospital and worryingly in general ICUs some are currently finding that the ratios have been changing to 2 to every one bed due to the additional work associated with treatments and ppe and I believe the currently modelling still shows demand will be somewhere between 8-30 patients for each ICU bed available.

 

[GrannyJen]

At the end of the day this is a once in a century event and normal "peacetime" standards of care cannot expect to be maintained. Another reason for everyone to take responsibility for themselves, isolate, and don't expect the NHS to sweep up after you.

The one glimmer of light further down the road is that it might finally enter some peoples heads too take a lot more responsibility for themselves regarding what they eat, drink, smoke and spend all day sat on.

 

[WelshGas]

I think I remember you saying that one ICU nurse and two nurses could manage two ICU beds. The plan in these field hospitals is a ratio of 1 specialist ICU nurse - supported by other "staff" - per SIX beds.

Also to be decided is if these field hospitals are to run along military lines: "you accept that you cannot do everything for everyone and target treatment on those most able to survive and with a maximum quality of life" or NHS lines: "continue business as usual, and assume resources are infinite".

Revealed: The challenges and dilemmas as NHS Nightingale prepares to open

The NHS and Army's project to convert London's ExCel into a 4,000-bed field hospital - a plan of unprecedented scale for this country - is grappling with major clinical and cultural tensions, as well as the huge logistical challenge, ahead of its official opening next week.

www.hsj.co.uk

Perfectly possible, especially as there will be no patient visitors. After all it is common for one ICU trained Doctor to look after 20 ICU patients and 10 HDU patients overnight, and unlike a normal ICU where each patient has a different diagnosis and problems all these patients are going to be very similar.

 

[Maxx]

It will be unusual for almost all patients on the ICU to be ventilated simultaneously, which contrary to popular belief is not the norm. Providing outreach to converted wards and theatres for such a large number of patients is also going to be challenging.

 

[AlanC]

There is now a Nightingale Hospital being set up at the University of West of England (UWE) for 1000 beds according to the local news.

Alan.

 

[Amarillo]

There is now a Nightingale Hospital being set up at the University of West of England (UWE) for 1000 beds according to the local news.

Two BIG questions.

Will they have the ventilators for all the beds. I know that British engineering firms are really stepping up to this challenge.

Do they have the staff for all these beds. I know that military medics, St John’s Ambulance, retired NHS workers, second year and final year nursing undergraduates and staff from other hospitals are all coming forward to help, but the new hospital in Newham will require 16,000 staff alone.

 

[Maxx]

Staffing and equipment will be very challenging. For some perspective, Bristol already has two large hospital Trusts, each normally run with around 1000 beds. ICU capacity at one site is normally 20 beds and around 40 beds at the other. Each Trust also employs approx 10,000 staff (including support and Admin/Clerical staff). You certainly won’t need the same volume of admin and support staff, but frontline clinicians make up at least 50% of those numbers.

 

[andyinluton]

Two BIG questions.

Will they have the ventilators for all the beds. I know that British engineering firms are really stepping up to this challenge.

Do they have the staff for all these beds. I know that military medics, St John’s Ambulance, retired NHS workers, second year and final year nursing undergraduates and staff from other hospitals are all coming forward to help, but the new hospital in Newham will require 16,000 staff alone.

.

They only have 400 beds so far not the headline 4000 that gets talked about. The article on the BBC last night was saying that its actually the layout of the wards that reduces the required staff numbers.
One nurse/doctor can observe a lot more patients when there are no privacy screens etc in the way. Having all the patients with the same infection & a standard treatment also reduces the nursing workload hugely.

 

[Amarillo]

.
One nurse/doctor can observe a lot more patients when there are no privacy screens etc in the way. Having all the patients with the same infection & a standard treatment also reduces the nursing workload hugely.

I get that the hospital won’t be at full capacity for a week or two - hopefully never. But each ward will need 24h cover. Two 12hr shifts might work in the very short term (days). Three shifts will be required for the longer term (weeks) and I wouldn’t be surprised if four or five teams are needed in normal times.

 

[jepotherepo]

This sounds rather nihilistic but these facilities may be best suited to looking after all those patients unsuitable for escalation (ie; maximal appropriate level of care is the ward and won't receive non-invasive/invasive ventilation). These patients can't safely be discharged and will need symptomatic management or palliation.

 

[AlanC]

Two BIG questions.

Will they have the ventilators for all the beds. I know that British engineering firms are really stepping up to this challenge.

Do they have the staff for all these beds. I know that military medics, St John’s Ambulance, retired NHS workers, second year and final year nursing undergraduates and staff from other hospitals are all coming forward to help, but the new hospital in Newham will require 16,000 staff alone.

Our daughter is a doctor at the Bristol Royal Infirmary (BRI) and she has said that as the wards have been emptied of non-urgent patients, the hospital is relatively quiet at the moment. The virus count in Bristol is currently quite low (137 confirmed cases as of yesterday) compared to some other areas. Let's hope it stays that way.

Alan

 

[pjm-84]

I'm on standby for another facility and aware of the 400-bed issue

 

[Vantastic2]

My brother informs me that The Royal Welsh show ground at Builth Wells is ear marked for a temporary morgue and also he has been asked to find as may refrigerated lorries as possible, sad times!

 

[alan middleton]

Perfectly possible, especially as there will be no patient visitors. After all it is common for one ICU trained Doctor to look after 20 ICU patients and 10 HDU patients overnight, and unlike a normal ICU where each patient has a different diagnosis and problems all these patients are going to be very similar.

Unfortunately they aren’t that similar. Some have additional medical problems. Also, the patients with covid 19 don’t tolerate the normal routines for moving and turning and tend to desaturate very easily making them more difficult to look after. Also, it is harder to do the normal tasks with full PPE kit.

 

[WelshGas]

Unfortunately they aren’t that similar. Some have additional medical problems. Also, the patients with covid 19 don’t tolerate the normal routines for moving and turning and tend to desaturate very easily making them more difficult to look after. Also, it is harder to do the normal tasks with full PPE kit.

That is why some serious decisions will have to be made with regard to which patients are offered ventilation and which will be transferred to the Nightingale hospitals.
Forget about " Normal " intensive care protocols this will be very different.

 

[Amarillo]

It appears that London’s Nightingale hospital was 96% empty over the Easter bank holiday weekend, with just 19 beds out of its current capacity of 500 being used.

Exclusive: Nightingale largely empty as ICUs handle surge

London's Nightingale hospital has remained largely empty, with just 19 patients being treated at the facility over the Easter weekend, HSJ understands.

www.hsj.co.uk

 

[WelshGas]

It appears that London’s Nightingale hospital was 96% empty over the Easter bank holiday weekend, with just 19 beds out of its current capacity of 500 being used.

Exclusive: Nightingale largely empty as ICUs handle surge

London's Nightingale hospital has remained largely empty, with just 19 patients being treated at the facility over the Easter weekend, HSJ understands.

www.hsj.co.uk

And?

 

[Jabberwocky]

How mindless........
Phone mast attacks...
.......one of the targeted sites serves Birmingham's Nightingale hospital.

Coronavirus: 20 suspected phone mast attacks over Easter

Vodafone says one of the "deluded" attacks was on a mast serving Birmingham's Nightingale hospital.

www.bbc.co.uk

Are we are in self destruct mode?

 

[Velma's Dad]

How mindless........
Phone mast attacks...
.......one of the targeted sites serves Birmingham's Nightingale hospital.

Coronavirus: 20 suspected phone mast attacks over Easter

Vodafone says one of the "deluded" attacks was on a mast serving Birmingham's Nightingale hospital.

www.bbc.co.uk

Are we are in self destruct mode?

People who believe that stuff should at least be obliged to pay back the cost of their education.

 

[T6 CFO]

How mindless........
Phone mast attacks...
.......one of the targeted sites serves Birmingham's Nightingale hospital.

Coronavirus: 20 suspected phone mast attacks over Easter

Vodafone says one of the "deluded" attacks was on a mast serving Birmingham's Nightingale hospital.

www.bbc.co.uk

Are we are in self destruct mode?

No we are not.

Most of the country are doing everything and more required of them.

Because we have a 24 hour news flow with an avalanche of social media we hear every bad thing it is possible to hear and it’s grasped by our media to get air time and sensational headlines.

To say it pi**es me off rather than concentrating on the good things is an understatement.

They are now busy telling people in care homes that they are being air brushed out. They have been told at least 4 or 5 times why this is but no. Far better to frighten the people in homes who are already in a difficult situation.

Rant probably not over.


Mike

 

[Amarillo]

And?

You might view it as good news, that there are not as many infections as feared.

Or you might consider it a hideous waste of money that could have been better spent on ramping up testing.

I suppose I'd far rather there were 481 spare intensive care beds in London than 481 too few.

 

[Benh76]

People who believe that stuff should at least be obliged to pay back the cost of their education.

seems harsh

not sure this guy is ill informed

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sociable.co