Covid UK: NHS Nightingale Hospitals ‘UNUSABLE’ as new strain spreads

NHS staff must start receiving the coronavirus vaccine urgently because so many are off sick, hospital bosses in England have claimed amid fears there are not enough nurses and doctors to open the Nightingale sites. 

The temporary purpose-built hospitals constructed for £220million to help fight the Covid-19 crisis were hailed at the start of the pandemic as a solution to the growing crisis in hospital capacity across the country.

But many are lying empty as doctors and nurses plead with their hospitals to vaccinate them after being told they must wait until early next year because they are a lower priority than the over-80s and those in care homes. 

Huge numbers of NHS staff are currently self-isolating or sick, with the most recent figures from last month suggesting around 30,000 were off. Some hospitals have hundreds of staff not at work at the moment, while others are allegedly asking them to give up pre-booked Christmas holidays or offer cash incentives to volunteers. 

The flagship Nightingale at the London ExCel, which saw the 940,000 sq ft exhibition centre converted into a hospital with space for 4,000 beds, is still on standby along with the centres in Birmingham and Tyne and Wear.

The hospital in Manchester is only open for ‘non-Covid care’, while the locations in Exeter and Harrogate in North Yorkshire are open as ‘specialist diagnostics centres’ – and the site in Bristol is only for ‘local NHS services’.

Senior members of the Royal Family including Prince Charles, Camilla and Prince William remotely opened three of the hospitals to great fanfare in April, while Captain Tom Moore cut the virtual red tape on another. 

But they have hardly been used, and concerns are now mounting over whether they ever will be – with doctors warning there are not enough staff as it is, and therefore insufficient numbers for the hospitals if they reopen.

There are also questions over why they cannot open after Prime Minister Boris Johnson warned the new variant of Covid-19 could overwhelm the NHS thanks to it being up to 70 per cent more transmissible than previous strains.

The Government has continually pushed a narrative that the NHS must be protected throughout the pandemic, with doctors saying there were more than 100,000 unfilled staff vacancies before the crisis even began. Labour have claimed that the NHS is now ‘trying to cope on the back of years of Tory cutbacks and understaffing’.

There have even been calls to employ some of the 90,000 student nurses and teaching staff across 84 university nursing departments in Britain to work at the Nightingale hospitals and help fill in the gap. 

Labour MP Khalid Mahmood added that the Nightingales were a ‘total waste of resources and money’, while one doctor said they must be ‘put to good use before someone starts mentioning expensive white elephants’. 

It comes as new analysis revealed a third of major hospital trusts in England currently have more Covid-19 patients than at the peak of the first wave of the virus – with the figure rising to more than half in the East and South West.

The NHS has insisted some of the seven sites are admitting patients and others will become vaccination centres. Meanwhile today: 

  • Italy became the fifth country to spot mutated Covid virus after infected British traveller flew to Rome;
  • There were calls for US authorities to join 32 nations blocking all visitors from UK amid the new outbreak;
  • Tory MPs urged the Government to ‘come clean’, recall Parliament and present evidence on the strain;
  • Sainsbury’s warned of shortages in salad, broccoli and citrus fruits as panic-buyers queued for supermarkets;
  • More than £45billion was wiped off FTSE 100 as the markets fell 2.6 per cent this morning amid rising cases.

NHS Nightingale Hospital London at the ExCel was announced on March 24 then opened on April 3. It is pictured yesterday

NHS Nightingale Hospital London at the ExCel was announced on March 24 then opened on April 3. It is pictured yesterday

NHS Nightingale Hospital Birmingham was opened on April 16, and is pictured above being constructed the week before

NHS Nightingale Hospital Birmingham was opened on April 16, and is pictured above being constructed the week before

The NHS Nightingale Hospital North West in Manchester (pictured in October) is now open for 'non-Covid care'

 The NHS Nightingale Hospital North West in Manchester (pictured in October) is now open for ‘non-Covid care’

NHS Nightingale Hospital Yorkshire and the Humber was opened on April 21, with beds on a ward pictured that same day

NHS Nightingale Hospital Yorkshire and the Humber was opened on April 21, with beds on a ward pictured that same day

Dr Chaand Nagpaul, British Medical Association (BMA) council chair, said the biggest limiting factor to increasing NHS capacity was workforce constraints – and doctors are already being ‘overwhelmed’ with coronavirus patients.

He told Sky’s Sophy Ridge on Sunday: ‘Unfortunately we entered the pandemic with a shortage of doctors and nurses – I think we have 80,000 vacancies in the NHS. You just can’t have a doctor or nurse in two sites at once.

How the NHS Nightingale hospitals were opened then put on standby 

NHS Nightingale Hospital London

  • Announced: March 24
  • Opened: April 3 (by Prince Charles)
  • Closed: May 15

NHS Nightingale Hospital Birmingham

  • Announced: March 27
  • Opened: April 16 (by Prince William)
  • Down to standby: May 5

NHS Nightingale Hospital North West

  • Announced: March 27
  • Opened: April 17 (by Duchess of Cornwall)
  • Closed: June 5
  • Put back on standby: October 12

NHS Nightingale Hospital Yorkshire and the Humber

  • Announced: April 3
  • Opened: April 21 (by Captain Tom Moore)
  • Radiology outpatient clinic: June 4
  • Back on standby: October 12

NHS Nightingale Hospital North East

  • Announced: April 10
  • Opened: May 5 (by Matt Hancock)
  • Back on standby: October 12

NHS Nightingale Hospital Bristol

  • Announced: April 3
  • Opened: April 27 (by Matt Hancock & Prince Edward)
  • Down to standby: July 6

NHS Nightingale Hospital Exeter

  • Announced: April 10
  • Opened in standby: July 8
  • First Covid patients: November 26

‘What’s probably better is to try and make sure we have as many doctors and nurses available on single sites to be able to provide care.’

He added: ‘With the NHS coming under enormous strain and hospitals already struggling to cope, it is absolutely vital that there is enough capacity and adequate staff levels to treat the rise in Covid and non-Covid patients coming through the door.

‘However, the reality is that we started this pandemic with serious workforce shortages, with just under 40,000 nurse vacancies and over 100,000 unfilled NHS staff vacancies.

‘This makes it very difficult to staff the Nightingales adequately to provide the service they were intended for. Doctors and nurses are already overstretched dealing with surges of patients with covid and other conditions in acute hospitals, and cannot be in two places at once.’

Ken Bremner, the chief executive of South Tyneside and Sunderland NHS trust, said making NHS staff wait for the Pfizer/BioNTech vaccine was ‘a kick in the teeth’ – a comment backed by four other anonymous bosses.

Another unnamed chief executive told the Guardian: ‘Frontline NHS staff should absolutely have been in the first wave [of priority groups] for the added protection this would give to them and, crucially, their patients.

‘There is a growing sense of frustration among staff who feel let down and now a sense of inequity because of the way it’s being distributed.’

And a third said: ‘There is growing disquiet in the NHS about how we have ended up prioritising people at the end of their lives for the vaccine over and above the NHS workers who are actually trying to care for them. It’s very, very odd.’

There have also been calls for student nurses to help fill in the gaps caused by staff sickness and absence.

Dr Ann Bradshaw, a retired senior lecturer in adult nursing at Oxford Brookes, wrote on Spiked: ‘There are approximately 30,000 student-nurse places in the UK each year, which, given nursing is a three-year course, means there are about 90,000 student nurses in total (notwithstanding dropouts).

‘Moreover, there are 84 university nursing departments throughout the UK, each with a body of nursing professors, senior lecturers and lecturers, many of whom will be registered with the Nursing and Midwifery Council, although they are not required to work clinically to maintain registration).

‘In this emergency pandemic, it would seem quite rational for these students and teaching staff to be deployed by government to staff the Nightingale Hospitals.

‘This is not even a novel idea. It in fact constitutes the former apprenticeship method of nurse training, which was overturned by the professional leadership from the 1980s onwards, against the view of ordinary nurses.’

And medical expert Dr Carol Cooper told The Sun: ‘Just a few months ago, Nightingale hospitals were the pride of the NHS, and now they lie mostly empty. They cost considerable money and should be used for patient care, as was intended. 

Health Secretary Matt Hancock speaks via videolink during the formal opening of Bristol's Nightingale Hospital on April 27

Health Secretary Matt Hancock speaks via videolink during the formal opening of Bristol’s Nightingale Hospital on April 27

An intensive care unit ward at the NHS Nightingale North East hospital in Washington, Tyne and Wear, pictured on May 4

An intensive care unit ward at the NHS Nightingale North East hospital in Washington, Tyne and Wear, pictured on May 4

Barriers at an entrance to the Exeter Nightingale Hospital are pictured on October 24. The NHS site opened on April 10

Barriers at an entrance to the Exeter Nightingale Hospital are pictured on October 24. The NHS site opened on April 10

‘A shortage of inpatient beds is already causing huge problems. Waiting times are up in A&E, and there’s been a worrying rise in patients waiting 12 hours or more, often on trolleys.’

She added: ‘There’s no easy answer, but Nightingale hospitals need to be put to good use before someone starts mentioning expensive white elephants.’

Shadow Health Secretary Jonathan Ashworth has echoed his concerns, saying: ‘We’re heading into the next NHS coronavirus crisis with hospital wards struggling without enough doctors, nurses and health care staff.

‘It’s all very well Ministers telling us they have Nightingales but if they can’t sufficiently staff existing wards how can they guarantee enough doctors and nurses at the Nightingales?’ 

Rupert Pearse, a professor of intensive care medicine at Queen Mary University of London, has said the ‘main problem’ is the availability of trained staff.

He tweeted: ‘Hospital staff are spread very thinly. We cannot shut down other patient services and re-deploy staff to intensive care or respiratory wards as we did in the spring.

‘Nightingale Hospitals won’t help because the main problem is the availability of trained staff. We are already ‘diluting’ our skilled ICU nursing staff with less well trained volunteers from other parts of the hospital. This is very much the long hard winter that NHS leaders feared.’ 

Labour’s shadow health minister Justin Madders said: ‘We know that at this time of the year is when the NHS comes under the most strain and that the surge in new Covid cases is putting hospitals in some areas under tremendous pressure.  

‘It is therefore concerning that there seems to be no sign of the Nightingale hospitals being used for the purpose they were originally intended.

Third of hospital trusts in England have more Covid-19 patients than during first-wave peak 

A third of major hospital trusts in England currently have more Covid-19 patients than at the peak of the first wave of the virus, new analysis shows.

In two regions – eastern England and south-west England – more than half of trusts are above their first-wave peak.

Other trusts have seen their numbers rise so rapidly that they could pass their first-wave peak within days.

The analysis found that of the 127 acute hospital trusts with a 24-hour (type 1) A&E department in England, 42 (33 per cent) had more Covid-19 patients on December 18 than at the peak of the first wave in the spring.

Examples include:

  • Mid & South Essex, which recorded 450 confirmed Covid-19 patients on December 18 compared with a first-wave peak of 374.
  • East Suffolk & North Essex, which had 185 patients compared with a first-wave peak of 143.
  • Barking, Havering & Redbridge, where there were 300 patients on December 18 versus a first-wave peak of 245. This is currently the only trust in London to have passed the peak.
  • Gloucestershire, which had 171 patients compared with a first-wave peak of 149.

In other areas of England, such as the North West, some trusts saw numbers hit a record high in the autumn before dropping more recently.

An example is Liverpool University Hospitals Trust, which saw a peak of 475 patients on October 30 but where the number now stands at 136.

But even in this region a handful of acute trusts are currently experiencing a new peak in Covid-19 patients, such as University Hospitals of Morecambe Bay.

Here the number stood at 180 on December 18, compared with a first-wave peak of 147.

Acute trusts manage all the major hospitals in England with A&E departments, inpatient and outpatient surgery, and specialist medical care.

The total number of Covid-19 patients in all hospitals in England – including mental health and community trusts – currently stands at 16,183.

During the first wave this number peaked at 18,974 on April 12. 

‘If there is spare staff capacity to open up the Nightingales then steps need to be taken to do that now. Nobody wants to see scenes of corridors full of sick patients again because the Government didn’t act quickly enough.’

It comes as thousands of doctors warn the NHS will struggle to cope with the ‘incredible demand’ facing the health service.

A survey of almost 8,000 doctors and medical students from across England, Wales and Northern Ireland conducted last week lays bare the mounting pressure on the NHS.

It highlights the level of worry felt by doctors and NHS staff, as the health service struggles to cope with rising numbers of Covid patients while dealing with a significant backlog of other treatments.

The results, published by the BMA, are from a survey conducted last week and before the tighter restrictions were implemented over the weekend.

Findings show that more than half of respondents said they had seen a significant increase in the number of Covid cases in the last two weeks.

One in three said current levels were higher than at the same point during the first wave, and another third said the level of demand for care of patients without coronavirus is now considerably higher than before the pandemic began.

Nine in 10 – the equivalent of 88 per cent – said they felt uneasy that they could not provide the standard of care they wanted during the pandemic.

Dr Nagpaul welcomed the tightening of Christmas restrictions saying although it was ‘hugely disappointing’ for many it was ‘absolutely the right decision and one which will save lives’.

He warned the NHS was already on the ‘brink of collapse’ and that tougher measures would give the health service a ‘fighting chance’ to cope with demand.

‘Whether it’s Covid or cancer, we are extremely worried that there may not be the capacity in our health service to provide care for everyone who needs it if the infection rates continue to soar,’ he said.

‘Our NHS and its staff are already at the point of collapse; with many hospitals full to capacity at the very start of the busy winter period, these tougher measures are necessary to five the health service a fighting chance to cope with the incredible demand it is experiencing and will likely continue to.

‘Doctors are telling us they’re already seeing significant increases in the number of Covid and non-Covid patients, and that they don’t believe their hospitals or practices will be able to cope in the new year.

‘The NHS provides care for us all, when we most need it. If it doesn’t cope, the consequences impact on each and every one of us; real people will suffer.’ 

He added there is ‘some hope’ that in a few months the vaccine rollout will ‘allow family, relatives and friends to mix together once again’.

An NHS spokesman said: ‘The Manchester and Exeter Nightingales are both admitting patients and all of the Nightingales in England are ready to support resilience in the NHS, with some already being used for outpatients, diagnostics, and scans, and some being prepared for additional use as large scale Covid vaccination centres.’