Mothballed Nightingale at London’s ExCel centre is prepared

Preparations are now well underway to reopen the mothballed NHS Nightingale hospital in London as a giant mass vaccination centre and facility for patients recovering from coronavirus.

Photographs taken this morning showed ambulances lined up outside the ExCeL centre in Newham, East London, as lorries arrived ahead of NHS staff beginning to use the 100-acre site as a huge hospital from next week.

The ExCeL will provide rehabilitation for patients who are recovering after an emergency hospital stay and who are not Covid-19 positive, with the intention of freeing up more beds in other hospitals for coronavirus patients.

However there have been concerns over the ability to staff the site properly, with around 50,000 NHS employees currently off sick. The number of beds is expected to be based on demand and staff availability.

It comes eight months after the ExCeL closed as a hospital on May 15 last year, having treated about 50 patients despite being originally planned to have up to 4,000 beds following its opening by Prince Charles on April 3. 

The flagship Nightingale was one of seven opened to great fanfare at the start of the pandemic, along with centres in Birmingham, Manchester, Exeter, Harrogate in North Yorkshire, Bristol and Washington in Tyne and Wear.

Senior members of the Royal Family, also including Camilla and Prince William, remotely opened three of the hospitals in April, while NHS fundraising hero Captain Tom Moore cut the virtual red tape on another.

But they have hardly been used, and concerns have been 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.

The ExCeL has also now been announced as being among the first seven mass vaccination centres which are set to open next week in a bid to help vaccinate the 13million in the four top priority groups by mid-February. 

It had initially been scheduled to start delivering jabs three weeks ago. The other six regional vaccination centres opening within days are at Epsom Racecourse; the Etihad Tennis Centre in Manchester; the Centre for Life in Newcastle; Millennium Point in Birmingham; Robertson House in Stevenage; and Ashton Gate Stadium in Bristol.

The ExCeL will be at the centre of the ‘London Mass Vaccination Programme’, operating seven days a week from 8am to 8pm. Other London sites which have been offered up for use by the NHS include the nightclub G-A-Y.

But the ExCeL should already be open and vaccinating the vulnerable, according to a handbook produced for volunteers by the Barts Health NHS Trust. 

It states: ‘The Vaccination Centre is due to open on December 14. It will then steadily increase its capacity, and is planned to be working a full capacity by April 2021.’ 

In London, epicentre of the crisis, Mayor Sadiq Khan has declared a ‘major incident’ as the spread of Covid-19 threatens to ‘overwhelm’ the capital’s hospitals.

City Hall said today that Covid-19 cases in London had exceeded 1,000 per 100,000, while there are 35 per cent more people in hospital with the virus than in the peak of the pandemic in April.

A ‘major incident’ means the ‘severity of the consequences’ associated with it are ‘likely to constrain or complicate the ability of responders to resource and manage the incident’.

Mr Khan has written to the Prime Minister Boris Johnson asking for more financial support for Londoners who need to self-isolate and unable to work, and for daily vaccination data.

He is also asking for the closure of places of worship and for face masks to be worn routinely outside of the home, including in crowded places and supermarket queues.

Mr Khan said: ‘The situation in London is now critical with the spread of the virus out of control. The number of cases in London has increased rapidly with more than a third more patients being treated in our hospitals now compared to the peak of the pandemic last April.

‘Our heroic doctors, nurses and NHS staff are doing an amazing job, but with cases rising so rapidly, our hospitals are at risk of being overwhelmed. The stark reality is that we will run out of beds for patients in the next couple of weeks unless the spread of the virus slows down drastically.

‘We are declaring a major incident because the threat this virus poses to our city is at crisis point. If we do not take immediate action now, our NHS could be overwhelmed and more people will die.

‘Londoners continue to make huge sacrifices and I am today imploring them to please stay at home unless it is absolutely necessary for you to leave. Stay at home to protect yourself, your family, friends and other Londoners and to protect our NHS.’

Hospitals are now stretched to breaking point as senior NHS figures warned that they could be overwhelmed by the surge in patients. In London, hospitals are set to completely run out of beds in just two weeks.

There are now 50 per cent more coronavirus inpatients, compared with during the peak in April, affecting every UK region. In Kent, one hospital warned that it may have to withdraw critical care from some of those it is treating.

Sir Simon Stevens, head of the NHS, told yesterday’s Downing Street press conference: ‘We’ve seen an increase of 10,000 hospitalised coronavirus patients just since Christmas Day.

‘That is of course all happening at what is traditionally the busiest time of year for hospitals and the wider NHS. The pressures are real and they are growing.’

He spoke out as the number of Covid-19 patients in hospital in England stood at a record 28,246 as of 8am yesterday. There were 3,697 admissions, including 913 in London, a record number for the fourth consecutive day.

Sir Simon said the number of admissions in London ‘was the equivalent of a new St Thomas’ hospital, full of Covid-patients, every day.

NHS England chiefs warned that even under the best-case scenario, there will be no space in hospitals in the capital for at least 1,500 seriously ill patients by January 19.  

The warning came from London’s medical director, Vin Diwakar, who said the health service will be swamped even after activating more ‘surge capacity’ and opening the Nightingale hospital.

Half of all hospital patients in London currently have Covid-19, and there are 7,034 of them. During the first wave the number peaked at 5,201 on April 9.

The official briefing, seen by the Health Service Journal, forecast the growth in Covid patient numbers over the next two weeks.

Under a best-case scenario, it will rise to 9,500 by January 19. Under the worst-case scenario, there will be 12,406. 

This is on top of the 7,401 beds required by non-virus patients. Even with maximising all available capacity and opening the Nightingale, there will be a shortfall of up to 4,600 beds, the briefing said. 

Hospital bosses are desperately trying to create more space by converting other wards.However, there are not enough staff, with shortages of nurses particularly acute. 

Usually each ICU nurse would look after one patient, but they are having to look after up to four. Doctors have been asked to do nursing shifts to ease the ‘immense’ pressure. 

Chris Hopson, chief executive of NHS Providers, said: ‘We are already using some of the Nightingales, including the ones in Exeter and Manchester.

‘These were always a last-minute insurance policy. If we’re going to staff them we are going to need to take staff away from existing hospitals.’ 

The pressure is having a catastrophic effect on non-Covid care, with cancer surgery and heart operations cancelled. The ambulance service is also struggling, with vehicles queuing at hospitals because there is no space in A&E.

Professor Rupert Pearse, an intensive care consultant at Barts Health NHS Trust, said: ‘The situation is definitely worse than the first wave.

‘We’re really struggling to provide the quality of care that we think patients deserve. The problem is not just in London.’

Asked on BBC Radio 4 if he believes the health service could be overwhelmed within two weeks, he replied: ‘I never thought in my entire career that I might say something like this but, yes, I do.’

In Kent, the Darent Valley Hospital, near Dartford, said it was at ‘Critcon level four’ – meaning its resources were overwhelmed.

Critcon level four requires tougher decisions about who to treat and some patients who would usually get critical care will not.