'We drew up the plan over a brew' - inside operation Nightingale

  • 4/1/2020
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London’s emergency coronavirus hospital at the Excel conference centre has been built from scratch over the last nine days in an unprecedented civil-military partnership and is ready to receive its first patients this week. Planning has involved soldiers with experience from Afghanistan and the west African ebola crisis, working in support of health service staff to create NHS Nightingale, which will be the largest hospital in the UK, with 4,000 beds at full capacity. The military team leader, Colonel Ashleigh Boreham, Commanding Officer, 256 City of London Field Hospital, an expert on building field hospitals in crisis zones, said the design and build was easily the largest he had undertaken in a 27-year army career. “We literally got a phone call, arrived here, met up with the NHS about nine days ago, sat around a table and basically did what you always do. We draw a plan up, over a brew, and then from that you start to build up a plan and create the product. It’s the biggest job I’ve ever done,” Boreham said. Up to 200 soldiers a day have been working alongside NHS staff and civilian contractors – including plumbers, carpenters and electricians – building row upon row of beds in cubicles in the vast 88,000 square-metre centre normally used for trade fairs and conventions. The principal challenge has been to complete the first phase of the build before hospitals in London and the south-east run out of room to treat patients, who are likely to require ventilator support to be kept alive while their bodies fight the virus. The NHS will not say exactly when Nightingale will be ready to open – other than to confirm it will be able to take patients “this week”, with up to 500 beds ready in the first phase. Nightingale’s size dwarfs field hospitals built by the army, which usually aim to treat a few dozen people with battlefield trauma injuries. “The difference here is that it [Nightingale] is at scale,” Boreham said. “We build hospitals that are trauma hospitals that are multi-discipline. This hospital is built with a much more simple plan with less variants so it supports a particular type of patient group,” Boreham added. The soldiers’ work has also included building a morgue, work that Boreham said had made “people focus their minds”. Although he worked as a medical commander in Afghanistan in 2013-14, Boreham said the closest parallels were the “experience from working with partners in West Africa during the Ebola crisis” which he said was working against a tight time scale and building up capacity incrementally. Royal Engineers have provided some additional specialist skills, while members of the Royal Anglian Regiment – some of whom were in Sierra Leone a fortnight ago - have helped with unskilled tasks so the contractors can work more efficiently. Lt Michael Andrews, a platoon commander with the Royal Anglians, said he and his troops had been at the Excel since Thursday. “So far we’ve been laying vinyl flooring in the medical bays, assisting with the build of the hospital beds and mattresses and other low level tasks, which frees up specialist trades.” Once operational, Nightingale will be staffed by NHS specialists working around the clock with the support of hundreds of volunteers from the St John Ambulance Service – and, after they have been trained, cabin crew from Easyjet and Virgin Atlantic, who are otherwise out of work. Richard Lee, the chief operating officer at St John Ambulance, said the numbers of his charity’s volunteers at the site would eventually reach 500 in around three weeks, split into two 12-hour shifts. “Our people have needed little encouragement to step up,” Lee said. The St John volunteers, who normally provide first aid care at public events, will work in pairs with nurses on site, tending to patients and ensuring they are as comfortable as possible.

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