What is the point of the Nightingale hospital

[Eastie77]

Reading this evening (Guardian, Independent) that the Nightingale hospital in East London has just 30 patients. Doctors and nurses working in over-stretched hospitals are saying the facility is failing to take any seriously ill patients and they cannot access vital pieces of medical equipment including ventilators and PPE which have been earmarked for the Nightingale but are sitting around unused

A lot of senior clinicians seem to think the whole project has been a pointless political exercise and I can see their point of view.
Since the Chief Medical Officer has said today we are 'probably' reaching our peak and the Nightingale is virtually empty doesn't it make sense to just close it and redeploy all of that vital equipment??

The problems with the Nightingales are 1. lack of staff and 2. difficulty of moving people on ventilators into them, not easy to transfer a critically ill person across a city.

I'd like to know where all these spare nurses are because the people I know in the NHS have their colleagues off sick with the virus, people working 12 hour shifts, some dont have PPE. The nightingales were planned to be staffed with people coming out of retirement, some army medics, dentists, st johns ambulance and airline staff. They would only ever be suitable for a few seriously ill and the rest would have to be mild cases.

It's bad enough to be in a makeshift coronavirus ward in a hospital with staff who are inadequately trained for the role - I wouldnt want to be in a Nightingale.

It was never intended to take critically ill patients. It's primarily for those with the virus who are likely to recover, and the idea was to free up ward space for those who are critically ill, or those with other conditions who might be at risk through being exposed to patients with the virus.

If it's not taking on the quantities expected then surely this is a good thing? I'm not a Tory voter and have no time for political grandstanding, but in these circumstances a contingency plan made sense.

Let's just hope these hospitals continue to be sparsely populated.

Exactly Gene many thousands of routine ops and ongoing treatments have been cancelled. Many clinics have been cancelled, waiting lists are backing up. It's not a long term option to continue this turning over parts of hospitals to make room for Covid patients, routine care needs to get back to normal asap so CV patients should to be moved to the nightingale hospitals, imo.

What @MLMsuperfan said

There were no fires this month in my town so I've started a petition to close the fire station.

I’m very glad they are there incase we needed them

It’s not just about extra beds, it’s about having people to staff them. The NHS is understaffed anyway. If you take staff from other hospitals to staff the nightingale, it leaves other hospitals short. Plus there’s the staff with symptoms who are self isolating but can’t get tested to see if they have it, leaving hospitals even shorter on staff. Plus staff are dying as there’s not even PPE so why would anyone want to volunteer to work there. I know some people do but they’d get a lot more volunteers if people were confident that they’d be kept safe with PPE. The nightingale hospitals were purely political designed to deflect attention from what a mess this government has made of the response to covid.

Ffs. If coronavirus suddenly brings down hundreds of thousands of people, all desperately in need of intensive care, where do you think those patients would go op?

The Nightingales were provided with ventilators I believe, you need to be pretty ill to need those. They were not provided with people who can staff them because the government ran the NHS down so badly that it just doesnt have the staff and you cant turn cabin crew into even a normal nurse far less an ICU nurse overnight.

Ill conceived idea but they might be some use if either less sick people went there or if all covid-19 patients were taken straight there and all the ICU staff moved there.

could the old folk that are recovering from covid (& maybe anything else, in case they are incubating) be moved into the Nightingale, to prevent possibly infectious people going back into nursing homes or into the community? Until they are at least a week past

Dunno why that isn't an obvious repurpose for the the N'gales.

People need care for a number of weeks with this virus. As new patients need intensive care the ones from a few weeks ago won’t be ready to leave. That’s when it will be needed

I have been deployed into the nightingale.

It is meant to be a step down unit / long term wean place. We're not getting many patients because they're either dying or getting better quicker in hospital. We've been told to expect an increase in patients in the next couple of weeks when the icus are at capacity with people who are really unwell and need a vent but have survived the virus and they're facing an influx of patients who arrive at hospital needing a ventilator. That's when we'll have patients. We'll get the ones who need a tracheostomy and long term weaning. It was never meant to be for looking after the sickest of the sick

The Nightingales will only accept staff if they work 48 hours per week. I can see their point re using less people = less people may be infected but I am sure many of the retired staff they thought they could use wouldn’t/couldn’t work that many hours.

The London Nightingale was designed for critical care patients s. It’s the Birmingham and possibly the others still in process that are going to take the less critically ill.

And the London Nightingale does have staff. Presumably a mixture of the returners and current staff from the nearby hospitals who will have been returners replacing their current role.

It does seem a bit odd that if there are patients on older less ideal ventilators that those patients haven’t been moved to the Nightingale but there might be a good reason for that.

The 48 hours may not be for deployed staff. I was just looking at NHS professionals request for staff at Nightingale Manchester.

I have been deployed into the nightingale. It is meant to be a step down unit / long term wean place

It's precisely the opposite in our regional Nightingale (Harrogate) - it has been set up only as an ICU overspill for ventilation, patients will be discharged back to general hospital care within 24 hours of coming off the ventilator

I was wondering if they were in some ways a kind of convalescent unit?
Makes me think of the sanatoriums that we had for TB

No, it’s because we are thousands of ventilators/ICU beds short of the number we are projected to need to deal with the crisis.

As far as I can tell, the idea is that the current ICUs will increase capacity by using operating theatres and using any spare equipment they might have or can get and the Nightingales will act as field hospitals to further increase capacity. That, combined with the cancellation of routine/non-urgent treatment to reduce the numbers of non-covid patients, should be enough to cope.

Wish they would use them for care home residents with covid.

@Crymblecrumble are you working there now? Where are they getting staff from?

@IheartNiles I got moved out of kids icu to go and help and I'm just sat around. But the majority of the staff are from NHS Professionals and a pp is correct in that when you sign up for NHSP you have to agree to work 48+ hours a week minimum

Is that what you’re working?
The whole thing seems generally uncoordinated. Our wards are half empty and staff bored while ITU is massive, constantly growing and sucking in staff. I’m really worried about the state the many patients with non covid illness are going to be left in.

@Willoman can you not understand that many elderly patients in care homes would not be best served by being admitted to hospital?

We are so wedded to one model of health care, and politically bad mouth anything else, that we discard other options without understanding that they could be better

I don’t disagree but I just hope people realise healthcare models like Germany and France are mainly p non profit health insurers. The systems they have provide universal healthcare (0.1% of Germans have no health cover). 85% of Germans are covered by these non profit insurers. The rest use private profit based insurers for the highest earners, some self employed and a few other groups.

@BubblesBuddy, I wouldn’t be against considering whether UK should switch to a healthcare system more like Germany or France but I would be aghast if we switched to an American profit based model that leaves so many without and if a person is unfortunate to get certain conditions and diseases can become bankrupt.

My fear is a Tory party would take us down the path of the American healthcare model. A fair few of them have links with profit based healthcare insurers.

On the subject of the Nightingale hospitals, I am glad they have been built and if they don’t get used all the better!

As far as I can tell, the idea is that the current ICUs will increase capacity by using operating theatres and using any spare equipment they might have or can get and the Nightingales will act as field hospitals to further increase capacity. That, combined with the cancellation of routine/non-urgent treatment to reduce the numbers of non-covid patients, should be enough to cope.

Useful info, thanks.

From Robert Peston’s twitter account:
“I’ve been sent the criteria issued to doctors for those #covid19 patients who are allowed to be transferred from hospitals to the emergency Nightingale ones that have been set up all over the UK to increase intensive care capacity. And what they show is that...
the Nightingales won’t take those who are really frail with serious comorbidities or are morbidly obese. So Nightingales are not taking those seriously ill patients who are most likely to die. They are being left in traditional hospitals. Doctors tell me they don’t understand...
the logic of these restrictions on who they can transfer and worry the Nightingales won’t therefore significantly reduce the burden on their own respective hospitals.
And another thing. When a patient is transferred to a Nightingale from a conventional hospital, the referring trust is required to supply staff to look after the patient and to supply relevant equipment. Which depletes the resources of the hospital thinking of making the...
patient transfer. And is a disincentive to making that transfer.”

This explains their low occupancy.
twitter.com/peston/status/1250892469882978304?s=21