Intensive care capacity must be permanently doubled, says Nightingale chief

Speaking to an online webinar hosted by the Royal Society of Medicine, Professor Charles Knight said London had around 800 critical care beds under normal operations but “there’s a clear plan to double intensive care unit capacity on a permanent basis”.

He added: “We must have a system of healthcare in this country that means, if this ever happened again, that we wouldn’t have to do this, that we wouldn’t have to build an intensive care unit in a conference centre because we had enough capacity under usual operating so that we could cope with surge.”

It would also mean the NHS would no longer be in a position “where lots of patients, as we all know, get cancelled every year for lack of an ITU bed,” he said.

Mr Knight said the Nightingale facility was an insurance policy for a potential second peak in covid-19 cases, but also a bridge to normal operations, by helping to take pressure off the primary hospitals. These plans were revealed by HSJ earlier this month.

The initial plan for the Nightingale, which is based in the Excel conference centre in east London, had been conceived when NHS leaders feared the capital’s intensive care units would be overwhelmed by covid-19 patients. However, the facility has remained largely empty as the city’s primary hospitals were able to provide a huge increase in capacity on their own sites.

But it can only fill that bridging function if the NHS in London also expands its critical care bed capacity to cope with the surge in demand that would come from future crises, according to Professor Charles Knight, chief executive of the London Nightingale.

He said it was “absolutely wonderful” that the peak in covid-19 cases was contained within primary hospitals, but it now means London has substantial excess critical care capacity.

He said the Nightingale can help the health system “radically reorganise itself” by providing critical care capacity to covid-positive patients, enabling trusts to create covid-negative spaces where infection risk is minimised and patients can attend for other health problems.

London’s hospitals currently have more than 800 covid-positive patients in critical care beds, which is around what would normal be full intensive care capacity.

“Clearly, in that bridging phase, the Nightingale can be used to decamp covid-positive patients out of hospitals to allow some of them to be essentially covid free,” Professor Knight explained. “That bridging function is dependent upon us establishing what everyone thinks is the right strategy which is that London must double its ITU capacity on a permanent basis going forward.”