Coronavirus: Thousands of NHS staff sent to Nightingale field hospital ahead of London surge

One intensive care doctor will be allocated to 42 patients at Nightingale Hospital, where draft plans suggest up to a fifth of patients may not survive

NHS hospitals are preparing for a surge in coronavirus patients planned for this weekend (UK government)

London hospitals are being asked to send thousands of NHS staff to work at the newly created Nightingale hospital ahead of its opening this weekend, when health chiefs fear the coronavirus surge will hit the capital.

The field hospital needs 2,000 NHS staff by the weekend, with existing hospitals forced to stretch their remaining staff and use agency staff, volunteers and recently returned retirees to backfill their wards.

London is gearing up for the planned surge in seriously ill coronavirus patients, with hundreds expected to be treated at the Nightingale Hospital, which has been built at London’s ExCel conference centre in the past week.

A leaked email to NHS staff seen by The Independent said workers from other hospitals deployed to the Nightingale would have a skills assessment and be grouped into three bands, one for intensive care trained staff, one for nurses needing to be upskilled, and one for those with only basic skills.

They will receive two days of online training, followed by one day of simulated training at the East London hospital. St John Ambulance volunteers are also being used at the site.

Up to a fifth of patients treated at the field hospital may not survive, according to draft plans seen by the Health Service Journal, which also revealed the hospital will have up to 2,900 intensive care beds, and around 700 beds for less sick recovering patients.

Patients who are frail and elderly, or have other health conditions making them more at risk from the virus, are less likely to be admitted, meaning many of the most seriously ill patients with coronavirus will be treated in existing intensive care units.

The document says London’s existing intensive care units should consider transferring patients to the Nightingale if they have “confirmed covid-19 related respiratory failure”, and require intubation for between one to 10 days.

The hospital will have a ratio of one intensive care consultant to 42 patients, supported by three intermediate doctors and three junior medics.

Nurses working at the centre who may not be experienced in critical care may be asked to carry out “unfamiliar” tasks in an emergency it said.

This could include safety checks of equipment including ventilators and nasogastric tubes; clinical patient assessments; administering and restocking medications via infusions; using a double pump system; responding appropriately to ventilator warning alarms; and emergency procedures where ventilator tubes are accidentally removed.

According to the document there are “significant challenges” with ensuring the safe transfer of patients between hospitals and the Nightingale site with around 60 extra ambulances able to move critical care patients being needed.

Transferring a critically ill patient on a ventilator is a high-risk event and requires a trained intensive care nurse or doctor to be with the patient. The document warns the drivers and staff able to do this are “rare”.

It said: “Appropriately trained and qualified clinical staff able to facilitate critical care transfers are also a rare commodity. Their skill set is in high demand within their base hospitals as they expand ICU capacity as part of the surge and super surge plans.”

Senior NHS sources in the capital told the HSJ the clinical model for the field hospital had originally been intended as one large intensive care unit but critical care doctors had expressed concerns about that.

One told the journal the new model was a compromise that would mean the Nightingale provides ICU care, but only for younger or fitter patients.

Similar field hospitals are being set up around the country including in Birmingham and Manchester.