The must-read stories and debate in health policy and leadership.

Coronavirus update

Over the last week, there has been lots of debate about what model of care should be provided at east London’s Nightingale Hospital.

Initially, a huge intensive care barn was being planned, taking the sickest patients from around the capital.

But it’s understood there was significant kick back against that idea from critical care departments, who doubted the logic of having lots of frail patients with comorbidities sent to the Nightingale, where none of the normal multispecialty support would be on hand.

These sort of concerns appear to have been to the fore in Manchester and Birmingham too, which are working on hospitals that will focus on step down care, rather than ICU.

A draft clinical model for the London facility, seen by HSJ, suggests a compromise was reached, whereby it will still have up to 2,900 intensive care beds, but will be largely focussed on younger/fitter patients requiring ventilation. It will also have around 700 step down beds for those being readied for discharge.

Moving away from London, University Hospitals of Birmingham Foundation Trust has suspended non-urgent cancer surgery, saying it was following latest national guidance, which advises how trusts can prioritise patients with cancer and related services.

It is the second trust HSJ is aware of to take this step. Barking, Havering and Redbridge University Hospitals Trust suspended routine cancer surgery last week. 

HSJ readers — both in the comments section and on Twitter — were quick to point out the casualties of the covid-19 crisis extended far beyond those who came down with the virus. One commenter, who said their cancer day surgery service was due to stop for six months, said: “We must not underestimate the number of non-covid deaths this pandemic will cause.”

Meanwhile, hospitals outside of covid-19 hotspots have told HSJ they are being denied vital information to help them prepare due to a lack of national data sharing.

Hospital chiefs are calling the lack of national data, such as critical care occupancy, a “black hole”, with daily figures only shared across regions.

NHS England, which holds this data centrally, has been called on to share the data more widely.