NHS quango boss Anthony Kealey has told West Yorkshire Councillors that the £multi-million Harrogate Nightingale hospital doesn’t have full hospital facilities, and isn’t suitable for patients who need a High Dependency Unit or Intensive Therapy Unit.
If there’s a Covid-19 ‘second wave’, it will be used for
“a limited type of inpatient care and support”.
Update 12 Oct 2020
Accounts of the cost of converting Harrogate Conference Centre into the Nightingale vary. First it was £15m, then £27m, then according to a list of Covid19 contracts compiled by Tussell, Leeds Teaching Hospitals was paid £41.735m for ‘The provision of temporary hospitals as part of the response to the Covid-19 Pandemic in England’.
(It looks as if the £15m was in fact the money paid to Dutch construction firm BAM. And the £27m was the set up cost, according to a written answer by Edward Argar MP (Minister of State, Department of Health and Social Care) to a question by Layla Moran MP.
He also told her the total set up costs for all seven Nightingales were approximately £220 million. So why does the Contract Award Notice for ‘The provision of temporary hospitals as part of the response to the Covid-19 Pandemic in England’ say the total contract value was £346,057,000 and the total award value £325,748,000?)
Update 20 Jan 2021
The total bill for the creation and eventual decommission of the Government’s emergency Nightingale hospitals is expected to be £532 million, according to junior Health Minister Lord James Bethell’s answer to a written parliamentary question on 11 January. As well as the set-up cost of approximately £220 million, the estimated £532m includes running costs, stand-by costs, and costs of decommissioning across all Nightingales.
Repurposed as cancer diagnostic clinic
The accountancy company KPMG scooped up nearly £1m for 3 months work on the Harrogate Nightingale Hospital. Huff post said it found the record of £923K audit fees relating to the constuction, using hospital trust spending records. So that must have been Leeds Teaching Hospitals Trust.
Hastily built inside Harrogate Conference Centre by a Dutch construction company with help from the UK army, and opened on April 21, none of the Harrogate Nightingale Hospital beds have so far been used.
The West Yorkshire and Harrogate Integrated Care System (aka Health and Care Partnership) has trumpeted this as a success story: evidence of how effectively District General Hospitals were emptied out at the end of March so they could admit and care for all Covid-19 patients who needed hospitalisation.
From 4 June 2020, the Harrogate Nightingale hospital was repurposed as a cancer diagnostic clinic providing CT scans, in an attempt to deal with the huge backlog of people with cancer symptoms that had built up without being referred for diagnosis when the Covid 19 pandemic hit.
“to provide additional critical care beds in our region should our existing hospital critical care provision reach capacity in the event of a second wave of covid-19 over the coming weeks and months.”
Harrogate Nightingale doesn’t have full hospital facilities and can only provide “a limited type of inpatient care and support.”
But at the end of September, Anthony Kealey, Locality Director – NHS England North (Yorkshire & the Humber) and West Yorkshire and Harrogate Health and Care Partnership, admitted to Councillors that it doesn’t have full hospital facilities and although it will be available until March 2021, it isn’t suitable for patients who need a High Dependency Unit or Intensive Therapy Unit – it can only provide
“a limited type of inpatient care and support”.
The West Yorkshire and Harrogate Integrated Care System Director, Ian Holmes, also agreed that people needing critical care are better off in hospital.
GP Dr James Thomas, Chair of NHS Airedale, Wharfedale and Craven Clinical Commissioning Group and joint senior responsible officer for the Partnership’s Population Health programme, said,
“The Nightingale hospital was set up for ITU [Intensive Therapy Unit] patients but we can look at using it for milder Covid-19 patients.”
Councillors’ scrutiny of NHS response to Covid-19 emergency
These revelations were made at the 30 Sept West Yorkshire Joint Health Scrutiny Committee meeting, after Calderdale Councillor Colin Hutchinson asked NHS bosses how the Harrogate Nightingale will function up until the end of March 2021. He asked if it was appropriate for critical care, and where the staff would come from – noting that the Chinese had used their shelter hospitals to take relatively mildly ill patients out of their homes.
Dr James Thomas admitted that it would take staff away from the area’s NHS trust hospitals.
Repurposing Nightingale hospitals to break the chain of Covid-19 household transmission is not on NHS bosses’ radar
None of the NHS bosses picked up on China’s use of its field hospitals as shelter for people at home with Covid19, in order to limit transmission of the virus within households.
This is a major route of infection, according to data from current contact tracing in West Yorkshire and the North West.
A British Medical Journal article, ‘Covid-19: breaking the chain of household transmission,‘ notes the high incidence of household transmission in places under local restrictions. It points out,
“In Wuhan … the epidemic was only brought under complete control when Fangcang (field) hospitals were introduced to isolate cases outside the home..”
“People who are unable to self-isolate safely at home could be accommodated in special isolation facilities such as hotels and hostels, an approach adopted by some other countries, including Italy, Finland, and Lithuania…Nightingale hospitals in the UK could be similarly repurposed to support isolation of infected people with mild-to-moderate disease. As medical and nursing care needs are mostly modest, the cost would be relatively low.”
Was there ever clarity about the Harrogate Nightingale’s purpose?
The original claim was that it provides 500 critical care beds as an overspill hospital for Covid-19 critical care patients – and the highest level 3 critical care beds at that, according to an April 2020 report by an independent online news service for the Harrogate district on the conversion of the Harrogate Convention Centre.
Level 3—Intensive care is for patients requiring two or more organ support (or needing mechanical ventilation alone). Staffed with one nurse per patient and usually with a doctor present in the unit 24 hours per day.
So why, when you look at the “about” webpage for the Harrogate Nightingale hospital, does it say it was set up for “less complex cases” in “up to 500 additional critical care beds”?
At the time, did anyone really know what the Harrogate Nightingale ‘hospital’ was for? And how could they expect to staff it safely, by taking staff from real hospitals across Yorkshire and Humberside that are chronically short staffed? Was this £15m public money well spent?
You can find out about critical care services in England on the Kings Fund website, here.