NHS Managing the Pandemic in Local Hospitals

Managing the pandemic in community hospitals

Over the past few months, Leicestershire Partnership NHS Trust's community hospitals have played an important part in dealing with the Covid-19 pandemic alongside our other NHS partners in Leicester, Leicestershire and Rutland.

The safety of patients and staff continues to be our top priority.

At the onset of the pandemic we set aside two of our 12 wards across our community hospitals to deal exclusively with patients who are Covid-positive, to support the demand for beds across the local NHS system. These were based at Hinckley and Bosworth Community Hospital.

In May 2020, we temporarily suspended the admission of patients to Feilding Palmer Hospital in response to the 'Covid-19: infection, prevention and control guidance', to ensure patient and staff safety. The small Victorian hospital does not enable safe social distancing to be maintained on the ward to prevent the spread of the Covid-19 infection. Read more here.

We had hoped that with some reasonable alterations to the site, we would have been able to reopen the Feidling Palmer ward as third red ward in the event that our two existing red wards at Hinckley and Bosworth Community Hospital became full. This was in preparation for a second and subsequent surge in COVID19 related admissions across Leicester Leicestershire and Rutland. However our site survey identified that building alterations at a cost of at least £92,000 would be required to enable this. This cost significantly exceeds our initial expectation.

We have an obligation to ensure any spending we make is good value for the taxpayer. We have therefore, as part of our ongoing review of national guidance and current demand for beds in the system, undertaken a systematic and comprehensive assessment of all 12 community hospital wards to see which are best suited to treat Covid-positive patients at this time and within the context of the wider local NHS system response.

A panel of senior healthcare professionals from the Trust assessed each ward against ten criteria in line with guidance issued by Public Health England on Covid-19 infection prevention and control. These criteria included: ability to meet two metre social distancing; isolation from other NHS services; availability of piped and bottled oxygen; whether additional building works would be required; and staff resilience.

The outcome of this review is that the two wards at Hinckley and Bosworth Community Hospital are the best placed to continue treating Covid-positive patients across our estate. They have a combined capacity of 47 beds; in recent days they have had as few as three patients. At the height of the pandemic the maximum number Covid-positive patients we have had at any point was 22.

Feilding Palmer Hospital has been assessed to be the least suitable of our 12 wards across Leicester, Leicestershire and Rutland to safely care for Covid-positive patients within the NHS system.

The appraisal panel identified significant limitations in respect of the ability to provide piped gases or to store oxygen cylinders in addition to the lack of staff and patient wellbeing areas. The proposed works would not have fully overcome these deficiencies.

This means that we will not be now progressing with Feilding Palmer recommencing admissions as a Covid-positive ward. On a positive note, this comprehensive review of all our community hospitals will enable us to vary the number of beds allocated to Covid-positive patients quickly and safely, depending on the current and future demand for such beds across Leicester, Leicestershire and Rutland.

The assessment also enables greater certainty as we and other NHS organisations continue to restore outpatient services at Feilding Palmer Hospital. Having Feilding Palmer as a temporary outpatient-only facility will be of significant benefit to the local community. Throughout the pandemic it has allowed a number of vulnerable people to continue to receive care and medication close to home. It will also allow other services, including physiotherapy, to re-establish clinics that were suspended because of the pandemic, and to support the local community while we adjust what our community hospitals can safely offer at this time.

Angela Hillery, chief executive of LPT, said: "To continue to keep our patients and staff safe, we've undertaken a comprehensive review of all 12 wards in our community hospitals in line with the Government's latest infection prevention control guidance, to assess their suitability in dealing with Covid-positive patients and preventing the risk of transmission.

"Feliding Palmer Hospital has been assessed as the least well suited ward to care for Covid-positive patients. We had hoped that with some reasonable alterations to the site, we would have been able to re-open the ward to temporarily treat covid-positive patients, however our review has identified that there would still be limitations for storing and providing piped oxygen on the ward and have safe socially-distanced staff and patient wellbeing areas. As our smallest and oldest hospital (opened in 1899), unfortunately its layout doesn't allow for social distancing or allow us to follow the Government's infection prevention control guidelines at this time.

"I recognise that Lutterworth residents have a great deal of affection for the hospital, and will be disappointed to hear there will be no early return to inpatient services. This is understood and we apologise if we have inadvertently raised their expectations through exploring the option. However, our decision is in the best interests of patient and staff safety, reflects the demand and capacity required at this time and therefore offers best value for tax payers money.

"The capacity at Hinckley has been more than enough to cope with the height of the pandemic dealt with by the whole NHS across Leicester, Leicestershire and Rutland in the spring. Our latest review will enable us to quickly and safely vary bed capacity across all of our community hospitals depending on current and future demand.

"Having Feilding Palmer as an outpatient-only facility will be of significant benefit to the local community. Throughout the pandemic it has allowed a number of vulnerable people to continue to receive care and medication close to home.

"It will also allow other services, including physiotherapy, to re-establish clinics that were suspended because of the pandemic, to support the local community while we adjust what our community hospitals can safely offer."

Staff from the inpatient ward have been temporarily transferred to other wards within LPT, mainly at Hinckley and Bosworth Community Hospital and St Luke's Hospital, Market Harborough.

Angela Hillery added: "We would want to reiterate that this remains a temporary measure while we are dealing with the pandemic. It will continue to be reviewed every three months, or when the situation changes and new government guidance is issued, if there is availability of a vaccine for Covid-19, or a substantial surge in Covid cases. When it is safe to do so, we look forward to re-establishing inpatient services as normal across all our community hospitals.

"We continue to be supported by the CCG in the temporary suspension of inpatient admissions at Feilding Palmer Hospital and the wider use of our community hospitals in supporting the local NHS response. Any decision about the future configuration and model of care in all our community hospitals will be led by the Clinical Commissioning Groups through an entirely different process. We would consult the local community before making any permanent change to the hospital's status."

Posted: Tue, 28 Jul 2020 16:31 by Josie Flavell

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