Exclusive: Mass expansion of rehab beds for covid planned

Several senior sources in the region said NHS England’s regional directorate wanted leaders to make suggestions for how the beds – which would follow the “Seacole” model being used in Surrey — could be provided by the end of the autumn months.

It may be an indication of a likely national plan to expand bed capacity across England ahead of a possible second peak of covid-19 demand in the winter. Crudely, if the 900 figure was repeated in other regions, it may amount to more than 6,000 additional beds England-wide.

HSJ understands the beds would be dispersed across multiple localities, rather than centralised in large facilities, such as the Nightingale facility in central Manchester, which was little-used and is now empty, but remains on standby. NHSE has suggested capital funding could be available, HSJ was told, and the North West plans could require tens of millions of pounds to deliver.

The likelihood of the plans coming to fruition is unclear, as the region is likely to be competing with others for capital funding. It is also unclear how many of the beds could be provided in existing buildings, but heightened infection control measures and increased demand for floorspace would mean that new pre-fabricated buildings are likely to be required in some areas.

The plans are being managed through the leadership “cells” for Greater Manchester, Lancashire and south Cumbria, and Cheshire and Merseyside, and have been submitted in the last week, it is understood. The clinical models are still being discussed, but there is likely to be a high degree of flexibility to be prepared for surges of covid and other respiratory patients. There will also be questions about revenue funding, to help staff the beds.

National NHS leaders are currently working on plans to expand NHS capacity with the aim of allowing the service to deal with a potential second peak, without relying on shutting down as many normal NHS services as it did in March. They are understood to be in negotiation with the Treasury about funding for several major parts of the next phase for NHS services.

The North West has been among the hardest hit regions during the pandemic, with covid-related hospital activity reducing at a slower pace than some other regions. As of 25 June, there were still almost 700 covid patients in the region’s hospitals (down from almost 3,000 at the peak). 

The region’s 650 bed Nightingale opened in mid-April and treated just over 100 patients in total, which was more than most of its counterparts. But it was not used to the extent that had been initially envisaged.

One senior source in the region said its low levels of activity should be seen as a success, as it meant the primary hospitals were able to cope with the peak.

Another told HSJ: “A lot of covid patients are really sick and need intensive rehabilitation and support. It takes them a significant amount of time to recover and the Nightingale was absolutely unsuitable for that.

“With the Seacole units we think it’s important to have these rehabilitation beds locally, where the surrounding teams such as GPs, community services and social care can be more involved and they have the right equipment.”

NHS England was approached for comment.