Nuffield Trust report calls for 'national stocktake' of the hospital estate in preparation for any future pandemic
Hospitals need to be better prepared for future pandemics, according to a report from the Nuffield Trust
A Nuffield Trust briefing has recommended a ‘national stocktake’ of the shortcomings of hospital estates in preparation for any future pandemics.
The briefing, entitled Overlooked but not overcome: smaller hospitals and the staff response to the COVID-19 pandemic, reviewed the response in the context of smaller hospitals, although the problems discussed are equally applicable to many of the large acute sites.
It highlighted estates-related problems, alongside issues around staff redeployment, communication, management, and insufficient support for staff, including their mental health and wellbeing.
The all-too-familiar problems of ventilation and oxygen supply within an ageing estate, often necessitating the redesign of wards or relocation of patients while implementing infection control protocols, also inevitably caused problems.
The authors of the briefing state: “Problems with estates actually drove, and constrained, the pandemic response.”
As well as the recommended ‘national stocktake’, the briefing says the Government’s Health Infrastructure Plan needs to be reviewed in light of the pandemic, with a view to ensuring robust supplies of oxygen, adequate ventilation, and appropriate infection control measures in all hospitals, not just planned new builds.
Working with Archus, Nuffield Trust is now conducting further research for the New Hospitals Programme, which it says should be incorporated into Health Building Notes and Technical Memoranda to inform future estates development.
This should include lessons for areas not covered by Health Building Notes, such as staff facilities.
Related to the issues of estates and buildings, most organisations struggled with bed capacity in all clinical areas, even prior to the pandemic, the research found.
It is essential, therefore, that the capacity of smaller hospitals meets their current need, particularly with regard to intensive care provision, as well as considering how surge capacity can be embedded within organisations.
The briefing recommends this may include upgrading non-clinical spaces so they can be used to safely bed patients during an emergency, through provision of spaces large enough for beds in cubicled areas, such as outpatients, oxygen in non-clinical spaces along with sufficient toilet and bathroom facilities. In addition, thought should be given to how operating theatre, recovery, and other similar spaces can be kitted out as ‘shadow’ ICUs.
Other issues that the authors conclude require more attention are: