Nightingale hubs - help /hinderance/PR exercise

[peridito]

www.bbc.co.uk/news/uk-59823652

The eight temporary "Nightingale" units will each house about 100 patients, with building starting this week

Royal Preston hospital in Lancashire
St James' University Hospital in Leeds
Lister Hospital in Stevenage
St George's Hospital in Tooting
William Harvey Hospital in Ashford, Kent
North Bristol Hospital
Solihull Hospital
University Hospitals Birmingham
University Hospitals Leicester

temporary structures will be set up in the grounds of hospitals so staff, equipment and emergency departments are close at hand.

Only those patients who are close to being discharged and need minimal support will be cared for at these facilities.

not much detail ,I wonder how much help they'll be by (presumably) providing a hot zone for recovering Covid patients.

But surely this will be extra pressure for NHS staff figuring out resources to accommodate them ,even if they're just erected and not used .And there will be no extra staff to provide care in them ..so increasing bed space by a 100 but no staff ,nurses ,cleaners ,caterers .

My local hospital in London has had to close wards because they can't staff them .

@the80sweregreat

Covid camp ! Yes, put them in the car parks in giant hubs , what can go wrong ? Where will the staff and visitors go to park their cars ? Most hospitals have a ring of steel around them with regards to parking anywhere outside too :( I hope they can be exempt from any fines at least if parking capacity is reduced.

This too. Our trust has such limited parking as it is, that staff HAVE to pay for (and thats the NHS provided parking, not the tripple priced private multi story), otherwise it's an inadequate and badly run P&R which makes you (if you start at 9am) either 2 hours early for work (because to be in on time for 9 you have to get the 7am bus) or up to an hour late because the bus never actually runs on time.

There has been absolutely zero forethought put into this whatsoever. Government have just decided they are doing it without any planning yet again.

I noticed none in Cornwall and none in the North East.

Basically if it reduces the chance of someone contracting Covid once they are in hospital for other reasons, then seems sensible. If it can be staffed.

@SantaHat

The biggest problem with the first set of Nightingales was that there wasn’t any staff for them so I don’t know where they hope to magic them from this time around with cases at an all time high.

I am aghast at the fact we are talking about erecting hospital tents in car parks but still refusing to take any mitigating steps whilst being virtually out of all testing options and instead the PM (who can barely explain where he’s been for the last 10 days) simply says enjoy new year but “be cautious”. Whatever the fuck that means.

This

@IWannaWishYouANutNutsChristmas

Wouldn't they just be discharged if they didn't need to be in hospital any more?

Not necessarily. A large amount of patients, especially the elderly, who are considered medically fit for discharge often need supported living arrangements and therefore don't have anywhere to actually go because there is no package of care in place for them leaving. This is because Social Care/Care Homes is so overwhelmed they don't have the capacity and no one seems to want to take in (or cannot physically take in and care for) their own elderly relatives.

This is what we call "Bed Blockers" and it can leave "healthy" people stuck in hospital for months while nurses argue with care homes who won't take them for x reason, relatives who won't take them for y reason but won't let them go into care settings who WOULD accept them and a number of other factors usually always related to funding.

One gentleman I looked after spent 9 months on a ward in this position while his family did the above. He couldn't go home because he couldn't look after himself and didn't qualify for carers going in anyway, the daughters couldn''t take him in because they had small houses and their own families to consider, the care home that would take him "is shit, we aren't putting him there", where they wanted to place their Dad refused to take him and anywhere else they couldn't afford to pay for the care for him to go there. It was a shit situation all round for a confused dementia patient and the staff that had to take care of him.

It's never as simple as "you are fine, go home", even in relatively normal circumstances.

@GreatBigBeautifulTommorow mostly sarcastic. But what happens if you are in hospital with something else and happen to test positive for Covid while you are in there. Can you just leave?

Apparently Boris Johnson only had three days off at Christmas ( was flamed for writing ten days as they reported in the Mail yesterday)
Still, he hasn't been around much.

This is a fantastic idea! A big issue at the moment in hospitals is patients who are not medically unwell, but simply have nowhere to be discharged to.

This will free up that capacity and make sure there are more beds available in hospitals.

@allbartwo if you had surgery and we’re fit for discharge but incidentally caught Covid but were still well you mean?
Yes you could go home.

@PinkTree7 who’s looking after them?

@PinkTree7

This is a fantastic idea! A big issue at the moment in hospitals is patients who are not medically unwell, but simply have nowhere to be discharged to.

This will free up that capacity and make sure there are more beds available in hospitals.

If they can go home, they go home. If they're waiting for placement, they clearly need care. Who is providing it in the tent in the carpark? That's the point everyone is making. Moving patients to a different area doesn't stop the need for staff.

@PinkTree7

This is a fantastic idea! A big issue at the moment in hospitals is patients who are not medically unwell, but simply have nowhere to be discharged to.

This will free up that capacity and make sure there are more beds available in hospitals.

That's not right.

It's not as simple as that they 'have nowhere to be discharged to'.

It's that they are awaiting assessments, social care packages and nursing home places amongst other things.

It's not a matter of just finding somewhere to put people.

They are called complex discharges for a reason.

[quote GreatBigBeautifulTommorow]@PinkTree7 who’s looking after them?[/quote]
They can clearly care for themselves .. 🤔
I've had covid and couldn't function that well for a few days , in a tent out the back of the hospital car park might have actually finished me off tbh ..

Where will staff, patients, visitors park?
Who will staff these units? We've had for years 'discharge lounges/wards' which house ready to be discharged patients needing packages of care /rehab but these only work if the funding /staffing is available to discharge.
I've been waiting two and a half years for surgery at one of the hospitals on the list the main excuse for my wait is lack of staff how on earth will they staff them? I guess the hospital will be breaching again when my op due next month is cancelled because the staff have been redeployed. The business manager told me government has said all patients waiting longer than 2 years for treatment must have a plan of care/have had surgery by march my consultant says he's ignoring it because its unachievable.
In the midst of all this are patients desperate for care, patients well enough for discharge but not able to leave and government promising solutions without looking at where the staffing is coming from.

Who's putting people in tents in car parks? That's certainly not an option we're looking at. We're looking at opening wards that aren't currently in use in the v short term and whether a deal can be done with hotels in the slightly longer term. We're certainly not sticking people with complex needs in tents ffs

@MollyQueenOfSocks

We can't staff our existing Hospitals - not even with agency staff and not even under Extreme pressures with Business Continuity plans being actioned.

Where the fuck do the government think the staff are going to come from?

The magic nurse tree?

Little more than a PR exercise, I imagine.

@GreatBigBeautifulTommorow

Many of the patients awaiting discharge are medically fit, and don’t require extensive care. Any care that is needed in these temporary facilities can be provided by healthcare assistants, caters and auxiliary staff.

I suspect volunteers could also be used. I’d be more than willing to help out in order to avoid further socially and economically ruinous restrictions being imposed.

@PinkTree7 existing HCAs and caterers are already stretched looking after patients in existing capacity.

Staff cannot be plucked from thin air and add to that the predicted 40% staff absence rate.

Volunteers would require police checks etc.

@GiveMeNovocain read the BBC and other reports, that's exactly what's being planned/executed.

OK so here's Chris Hopson MHS Providers CEO, explaining how they're going to be staffed.
But note some of the replies.

twitter.com/chrisceohopson/status/1476595499239149568?s=21

I saw a new Nightingale Hospital yesterday. At Pontoon Dock in London.

This reminds me of when I did work on a hospital ward and a visitor came to me to offer one of their beds from their spare room at home as he'd heard that the "NHS is short of beds".

He couldn't understand why we weren't begging for seconds from Bensons for beds, as he was sure they'd be happy to donate!

[quote MollyQueenOfSocks]@IWannaWishYouANutNutsChristmas

Wouldn't they just be discharged if they didn't need to be in hospital any more?

Not necessarily. A large amount of patients, especially the elderly, who are considered medically fit for discharge often need supported living arrangements and therefore don't have anywhere to actually go because there is no package of care in place for them leaving. This is because Social Care/Care Homes is so overwhelmed they don't have the capacity and no one seems to want to take in (or cannot physically take in and care for) their own elderly relatives.

This is what we call "Bed Blockers" and it can leave "healthy" people stuck in hospital for months while nurses argue with care homes who won't take them for x reason, relatives who won't take them for y reason but won't let them go into care settings who WOULD accept them and a number of other factors usually always related to funding.

One gentleman I looked after spent 9 months on a ward in this position while his family did the above. He couldn't go home because he couldn't look after himself and didn't qualify for carers going in anyway, the daughters couldn''t take him in because they had small houses and their own families to consider, the care home that would take him "is shit, we aren't putting him there", where they wanted to place their Dad refused to take him and anywhere else they couldn't afford to pay for the care for him to go there. It was a shit situation all round for a confused dementia patient and the staff that had to take care of him.

It's never as simple as "you are fine, go home", even in relatively normal circumstances.[/quote]
Thanks @MollyQueenOfSocks.

Older people who can't be discharged because they have care needs due to things like dementia seems like a group that would need high staffing levels rather than the group who could more or less fend for themselves as @allbartwo suggested.

[quote GreatBigBeautifulTommorow]@PinkTree7 existing HCAs and caterers are already stretched looking after patients in existing capacity.

Staff cannot be plucked from thin air and add to that the predicted 40% staff absence rate.

Volunteers would require police checks etc.[/quote]
And a shit load of training. As a qualified HCP I can’t go on the bank without doing approx 70 hrs of unpaid mandatory training. None of which is clinical as such. It’s all manual handling, fire, infection prevention, information gov, terrorism prevention.

A non qualified volunteer is going to need additional training as well.

An army of volunteers is only any good if you lived during WW2
These days you need all sorts ( as detailed below ) and who has time to do all those online mandatory training up that would be required too? Can you imagine the ' red tape ' under your gazebo trying to help a frail elderly person back to feeling well again after covid?
Ditto schools too , which is why our one doesn't have any volunteers at the moment

@Nappyvalley15

I saw they relaxed the immigration requirements on care workers so maybe they plan to ship some in from overseas to staff these nightingales. Just a guess.

Not sure this could happen quick enough or if they will get many takers given many were made to feel so unwelcome due to Brexit. Did the same for lorry driver shortage and apparently they had 8 apply