Nightingale hospital diverts equipment from London’s struggling intensive care units for just 30 patients

East London’s NHS Nightingale hospital has been criticised by doctors and nurses who say their units are overstretched and lacking vital equipment

Shaun Lintern
Health Correspondent
,Tom Peck
Thursday 16 April 2020 10:23
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London's Nightingale Hospital: What you need to know

London’s NHS Nightingale hospital is failing to help the capital’s “drowning” intensive care units and has diverted much-needed equipment away from the city’s hospitals, clinicians have told The Independent.

The vast new hospital, created in just 10 days at the ExCel conference centre in east London, had just 30 patients on Tuesday, according to one worker, while at hospitals across the city patients were being treated in makeshift units with “dangerous” staffing levels.

One senior London nurse with an overview of intensive care across the capital told The Independent: “It hardly has any patients and we are totally over capacity. Staffing levels in some ICUs are unsafe and dangerous.

“It seems like we are screaming into a vacuum and no one can hear us. Some hospitals are drowning, we need the help now.”

Doctors and nurses from across the city have complained they have been unable to source vital medical equipment such as ventilators, oxygen analysers and protective equipment for staff, with suppliers saying deliveries have been earmarked for the east London site.

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The problem could extend to elsewhere in the UK as more Nightingale hospitals open in Birmingham, Manchester and Harrogate.

An email from one company to a hospital in the north of England, shared with The Independent, revealed a request for equipment would not be met because of the “high demand to fulfil orders for the NHS Nightingale in London and other similar initiatives across the UK, we are not fulfilling any orders”.

One anaesthetist in London said there was a feeling among senior clinicians that the Nightingale was “a political exercise and of little practical use”.

They added: “We are still running low on basic equipment, including to deliver medicines that need to be delivered in precise quantities, like syringe drivers and pumps.

“Our usual ICU ventilation capacity is 10. We currently have 30 anaesthetic ventilators which are being used for ICU patients. They do the job but are not ideal.”

He said: “[The Nightingale] must have equipment for a hundred-plus ICU patients. That means there is a lot of kit there that is not being utilised, while patients are being treated elsewhere with equipment that is not designed for that purpose.

“What we want to know is how many gowns, how many ventilators, how many everything, are sitting unused at NHS Nightingale?”

The Nightingale hospital was opened with an initial capacity of 500 patients which could be extended to 4,000. It was constructed ahead of a feared peak in coronavirus cases which would have overwhelmed the intensive care capacity of London hospitals.

Alongside this, many NHS hospitals have created thousands of extra beds after cancelling routine surgeries and converting areas into makeshift ICU wards which has allowed the city to take the brunt of the Covid-19 infections.

But some wards have been forced to stretch their staffing levels, with staff from other parts of the hospital being used to care for ventilated patients and those needing oxygen support.

One nurse said the supplies of protective kit for staff, or PPE, were a major challenge, adding: “At one point we were actively considering and practising using plastic bags until we got a delivery just in time.

“I’ve been told the Nightingale has plenty of PPE and is using it for training, but I am standing here with completely inadequate PPE and not enough for my staff caring for patients.”

They added that staffing levels were “dangerous” and they had witnessed mistakes and errors made because of the pressures on staff: “I witnessed a drug error where a patient was given the wrong medication which could have caused extreme harm. A one-to-six nurse-to-patient ratio is never going to be safe or fine. There will be increased morbidity and mortality because of errors.”

They said the Nightingale was only taking “the most well” patients, adding: “The number of patients going there is so small. But we have patients in the here and now.”

Another consultant working in intensive care at a hospital said they still had extra space but added the Nightingale only wanted to take “straightforward patients” saying: “The trouble is there aren’t really that many. They’re all sick, especially the young ones.

“We’re still doing it safely. But what’s safe anyway? A couple of months ago we wouldn’t have thought ventilating sick people for extended periods on anaesthetic machines was particularly safe, but now it’s fine.”

A member of staff from the Nightingale Hospital told The Independent there were 30 ventilated patients getting good care.

One doctor said patients were still best cared for in hospitals during the worst of the sickness adding there was still spare capacity in the city and patients were being transferred between hospitals when needed.

They added: “It’s too hard to predict who will need services in an emergency that aren’t available at the Nightingale.”

Despite the email seen by The Independent and testimony of staff, an NHS England spokesperson denied any equipment had been diverted from the Nightingale.

They said: "There remains spare capacity in the critical care network across the capital to look after all coronavirus patients and others who need our care, and it is incredibly reassuring for both staff and patients to have backup capacity at the Nightingale to alleviate pressure on ICU departments where needed.

“No supplies or equipment have been taken away from other teams to stock the NHS Nightingale London, and arrangements exist, as they always have, for hospitals to share supplies with their neighbours if needed, which the Nightingale has already been doing.”

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