Coronavirus: Leading London hospital rushes to create 600 intensive care beds

Virtually all outpatient services at Barts Health Trust in London are now taking place remotely, as trust creates 600 intensive care beds across four hospitals

One of the country’s largest hospital trusts is rushing to create up to 600 intensive care beds, but this alone will not be enough to cope with a predicted surge of 1,000 coronavirus patients needing ventilation.

An operational planning document for London’s Barts Health Trust reveals the hospitals will be relying on the newly created Nightingale hospital at London’s ExCel conference centre to take the hundreds of extra patients.

The document reveals the scale of reconfiguration of services at the trust, which runs the main Royal London trauma centre hospital, in Whitechapel, as well as three other hospitals across East London.

It normally has around 118 beds for patients needing ventilation, but the document reveals modelling estimates of the impact of coronavirus means the trust’s East London catchment could need up to 1,000 ventilated beds.

A total of 400 will be provided at the new Nightingale NHS hospital at the ExCel conference centre, leaving the trust rushing to create the rest.

The pandemic plan said the trust was aiming to create 260 beds by the end of March, adding: “We then plan to scale up to around 420 beds across our sites by mid-April, provided we can staff and equip them. By this point, we aim to have just over 200 beds at St Bartholomew’s, around 150 at The Royal London, 35 at Whipps Cross and 36 at Newham.”

The trust is also building new wards in unused space on the top two floors of the Royal London hospital, adding: “This is a very ambitious project to deliver within a few weeks, but we are determined to achieve it if at all possible. We are at an early stage but our ambition is to create up to 180 ventilated beds during April in this space, taking our total to just over 600 across our sites.”

The document said achieving these extra beds will depend on a “Herculean effort by staff” who have to be re-deployed and re-trained in just weeks.

In a warning that will be mirrored for hospitals across the country, the trust said the challenge was not just for intensive care beds but also general hospital beds, which will be needed to care for some Covid-19 patients.

It added: “Our modelling suggests that the number we will require exceeds our current capacity, particularly when the scale-up of ventilated beds is taken into account.”

It is looking to use some local private hospitals to provide extra beds and is aiming to discharge patients within two hours of being ready to leave, with community services asked to assess their ongoing care needs once they are home.

The trust, like many others, said it had already “switched the majority of outpatient services to remote working (by video or telephone) in a matter of days”.

It added: “Virtually all outpatient services will have to operate remotely in the period ahead and we will probably suspend some or all services at the peak of the pandemic in order to release staff.”

Trust chief executive Alwen Williams said: “In order to meet this challenge, we will all need to think very differently about what we can do, and what our hospitals can do.

“We will have to make changes to the set-up of our hospitals, which would have been difficult to imagine only a few weeks ago, and we must do so very quickly. Many of these changes are already underway, and huge efforts are already being made to re-imagine and reorganise our system of care.

“This document summarises the plans we are making at Barts Health, plans we know will need to adapt and change, but plans which I hope will allow us all to succeed in the weeks ahead.”