Nightingale hospitals stand empty despite surging Covid cases as medics warn of staff shortages

The flagship Nightingale hospital is being dismantled as medics warn that there are not enough staff to run the facilities despite the NHS being at risk of being overwhelmed by coronavirus.

Amid surging virus case numbers, elective surgery is being cancelled as the number of patients in hospitals in England passes the peak of the first wave in April. 

Although the NHS is “struggling” to cope, the majority of the seven Nightingale hospitals, created at a cost of £220 million, have yet to start treating Covid-19 patients during the second wave. The Exeter Nightingale has been treating Covid patients since mid-November. 

The facility at London’s Excel centre has been stripped of its beds and ventilators.

The NHS has told trusts to start preparing to use the overflow facilities in the coming weeks, but bosses have failed to explain how they will be staffed.

It comes as Monday saw a record 41,385 lab-confirmed coronavirus cases. Hospitals have yet to see the impact of any Christmas social mixing because of a lag between infection and admission.

Dr Yvonne Doyle, the medical director at Public Health England (PHE), said: “This very high level of infection is of growing concern at a time when our hospitals are at their most vulnerable.”

The latest Government figures show that there were 20,426 beds occupied with confirmed Covid-19 patients in England. The previous peak was on April 12, when the figure stood at 18,974.

Paramedics in London saw one of their “busiest ever days” on Boxing Day with almost 8,000 call-outs, up more than 2,500 on the 5,217 received on the same day last year.

Matt Hancock, the Health Secretary, and NHS staff at the opening of London’s Nightingale Hospital in April Credit:  Stefan Rousseau/PA

Saffron Cordery, the deputy chief executive officer of NHS Providers, said the pressures will soon be “more widespread across the country” as a new variant of the virus spreads, but warned that “we can’t conjure staff out of thin air” for the Nightingale hospitals.

Her comments were echoed by Dr Katherine Henderson, the president of the Royal College of Emergency Medicine, who said that you can’t “whistle up an ITU nurse”.

She said hospitals under the most pressure have already begun cancelling elective operations and emergency departments were “struggling” to cope with demand.  

“If you can get a grip on community transmission and suppress the virus then you can start doing other things,” she told The Telegraph. “But you cannot have the operating theatre open when you are in the soup of Covid – it is dangerous. You don’t have the beds that you need and you don’t have the staff that you need.”

Birmingham and Sunderland Nightingales on standby

They were opened with great fanfare at the beginning of the coronavirus pandemic – vast new facilities designed to save the NHS.

But as the UK is gripped by a second wave of Covid, the £220m Nightingale hospitals lie empty, with medics warning that, even if they are needed, they do not have the staff to open them.

On Monday, the hospital in London’s Excel centre not only had no patients, it is understood to have been stripped, with beds and ventilators missing. Barriers protecting the facility had been removed, partition boards which separated beds were stacked outside and signs directing ambulances lay on the floor.

Partition boards are stacked up at the Nightingale Hospital in London Credit: Heathcliff O’Malley

A discarded sign for guiding ambulances lies against a wall at the London site Credit: Heathcliff O’Malley

A single security guard watched the door, while nearby residents said that they had seen oxygen tanks, previously under 24 hour guard, being removed in November.

A contractor who helped supply and set up the facility told The Telegraph it was “disgusting” that it had been dismantled and a colleague, who was working at the site two weeks ago, said the facilities inside had been “ripped out”.

Meanwhile, the Nightingale at Birmingham’s NEC and the one in Sunderland are also empty but on standby, while Manchester’s is open for “non-Covid care”, with that at Harrogate being used as a “specialist diagnostics centre” and Bristol’s deployed for “local NHS services”.

Birmingham’s Nightingale can be opened in 72 hours if needed, it has been claimed. But Ian Sharp, the clinical lead for elective care at University Hospitals Birmingham (UHB), said that, with hospitals in the region full, “taking staff out of those organisations to open what is effectively a field hospital fills many of us with dread” and was therefore being treated as a “last resort”.

Workers construct facilities at Birmingham’s Nightingale Hospital in April Credit: Jacob King/PA ‘We can build physical capacity, but it takes many years to train staff’

Whilst the Nightingales lie empty, hospitals are struggling to cope with demand.  

Dr Alison Pittard, the dean of the Faculty of Intensive Care Medicine, warned: “We can build physical capacity, we can get equipment and consumables relatively quickly, but it takes many years to train staff to do the job, and no more so than in critical care.”

The NHS is currently not recruiting for the London centre, with jobs only available in the North-West, Exeter and Yorks and Humber. However, NHS England insists the facility “remains on standby and will be available to support the capital’s hospitals if needed”.

Saffron Cordery, the deputy chief executive of NHS Providers, said: “We know that the rate of Covid-19 admissions is rising and some trusts are reporting up to three times the number of Covid patients than at the peak of the first wave.”

She added that the Nightingales were “an insurance policy” and “it is possible that they will be used in the near future” but warned: “They will need additional staff, which is a resource currently in short supply.”

A poster at the Excel centre in London, where the capital’s Nightingale hospital was set up Credit: Heathcliff O’Malley

Amanda Pritchard, the chief executive of NHS Improvement and NHS chief operating officer, wrote to trusts on December 23, instructing them to “mobilise all of their available surge capacity over the coming weeks”.

This should include using private hospitals, providing mutual aid for struggling facilities, and “planning for use of funded additional facilities such as the Nightingale hospitals” as well as making use of community capacity and empty hospice beds, she said. 

But medics have been warned that the first thing to be sacrificed will be elective surgery, such as hip operations, with some already cancelled at the busiest hospitals. 

Dr Pittard said it was “different from the first wave” as hospitals were trying to keep all other services running, which means extra patients and that staff from other disciplines are not free to help with Covid patients.

She told The Telegraph that trusts did not want to cancel surgery but “the only way that we can treat everybody is to reduce the admissions due to Covid”, adding that the only way to do this was for members of the public to follow the rules and remember simple steps such as maintaining social distancing and washing their hands.

“We are so close to getting this under control with a vaccine if we can just keep admissions down long enough,” Dr Pittard said.

“Everyone is tired of the various tiers, having to wear masks and things like that, but we need to just hang on in there until we can get the vaccine distributed. Everyone just needs to bear with it for a little bit longer to keep the pressure off hospitals.”