The ExCeL exhibition centre in East London will reopen its doors as the NHS Nightingale Hospital later this week after being converted in just a matter of weeks.
The site is the first of three planned emergency hospitals in England, with two more expected to follow in Birmingham and Manchester.
According to The Guardian, the Nightingale will eventually function as a 4,000-bed hospital, with an initial capacity of 500 beds with ventilators and oxygen.
The hospital will be run by a combination of NHS staff, military medics and volunteers, including first-aid trained cabin crew from both easyJet and Virgin Atlantic.
How was the hospital built?
The Ministry of Defence and the NHS worked together to create the new hospital from scratch in an effort to accommodate rising numbers of Covid-19 patients.
Images shared by 10 Downing Street show a combination of tradespeople and military personnel – including from the Royal Gurkha Rifles – working to adapt the 100,000-square-metre space.
Leaked plans obtained by the Daily Mail detail separate areas for “invasive” and “non invasive” treatment, as well as “recovery” and “discharge” spaces. According to a contractor working on the project, there will also be two mortuaries on site.
The building looks as if it will be run like a corridor, with patients entering the facility through the east entrance and being discharged from the west entrance.
Wired reports that “the hospital will have two mirrored paths”, with patients being placed into either the “invasive or non-invasive ventilation areas (the former involving intubation, the latter wearing a face or nose mask)…
“Each section of the 600-metre long convention hall will be broken up by partition walls that are being installed right now by contractors,” the magazine says.
The Mail adds that across the river, London City Airport has suspended all private and commercial flights and will now be used by the government.
In the coming weeks, the Manchester Central Convention Complex and Birmingham’s National Exhibition Centre will join ExCeL London in further boosting NHS capacity.
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What are the challenges involved?
According to experts, speaking to Wired, the two primary challenges when launching an emergency medical facility are location and cleanliness.
Martin Bricknell, professor of conflict, health and military medicine at King’s College London and an expert in the design and function of field hospitals, told the magazine: “It’s probably one of the biggest covered spaces in London and therefore as a location that gives you maximum flexibility for how you might use it. It’s probably one of the best in London.”
This is echoed by Eric Pitts, a logistician with Doctors Without Borders, who said: “You’ll have a large open space, and different levels of circulation where you can control the flow of people coming in and out.”
Wired reports that powering the hospital equipment “shouldn’t be much of a problem” owing to the volume of people and facilites already available at the conference centre. The site is also close to an airport, meaning that patients from across the country could theoretically be moved by air to the hospital.
“Exactly how this will operate with clinical protocols, I’m sure the team is thinking through,” Bricknell added.
One of the main clinical challenges is hygiene, which Wired notes is a particular challenge with coronavirus as the virus has “been shown to last long on surfaces in the form of droplets”.
Pitts told the magazine: “You need to look at how to properly lay out the patient flow to guarantee infection flow, and how to design the walls and floors so they’re easy to clean. The main challenge in adapting an existing structure is how the existing structure is set out.”
Who will staff the hospital?
Sky News reports that Virgin Atlantic has begun writing to 4,000 of its employees today, prioritising those who already have skills – such as CPR training – that can be put to good use at the sites.
EasyJet has already written to its 9,000 UK-based staff, including 4,000 cabin crew trained in CPR, to invite them to give their time to the NHS, the broadcaster adds.
These volunteers will be drafted in to perform support roles, “such as changing beds under the guidance of trained nurses”, according to The Guardian. The staff will continue to be paid by the airlines.
According to the paper, doctors have expressed concern about where the specialist medics and nurses to staff the site will come from. One doctor, who spoke anonymously, said “…it is becoming more clear there is not a cavalry but just more space for us to spread into, but with the same number of staff”.
Wired reports that staff working at the Nightingale are being asked to leave their families and live on or around the site for weeks.
NHS England chief executive Simon Stevens described the work that will be carried out at the Nightingale as “a model of care never needed or seen before in this country”.
He added: “Our specialist doctors are in touch with their counterparts internationally who are also opening facilities like this, in response to the shared global pandemic.”
