City’s hospitals have withstood the crisis and will be ready for second peak, health chief tells colleagues
STAFF TESTING, PPE STOCKS, HOW MANY PATIENTS HAVE COVID-19, RESTORING SERVICES, STAYING ALERT – AND WHAT HAPPENS NEXT
HEALTH bosses have revealed the extent of the fall in the number of Covid-19 patients being treated at Leicester’s hospitals since the height of the outbreak.
University Hospitals of Leicester NHS Trust held its latest board meeting online on Thursday. Here’s what’s we have learned:
HEALTHIER PICTURE
On most days in May, fewer than 150 Covid-19 patients were being treated at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital.
The number in intensive care or high dependency beds was fewer than 20 throughout the last month.
This compares favourably with mid-April, when more than 200 Covid-19 patients were being treated, with more than 55 needing the highest level of care. In the last week of May, about 15 were in intensive care.
Before the peak, hospital bosses had created space for 300 intensive care beds across the trust’s sites.
RECOVERY RATES
As of June 1, 782 patients who had tested positive had been discharged by Leicester’s Hospitals.
They were either sent home to recover or transferred to community hospitals or care homes. About a month ago, it was 535.
Speaking at the time, Andrew Furlong, medical director at Leicester’s hospitals, said: “It’s always a joy when a patient is well enough to leave hospital.
“To see so many of those we have cared for, including those who have been extremely poorly, go back to their homes and families is a huge comfort and boost for our hard working team.
“We wish them all the best for their continued recovery.”
In all, 363 patients have died at Leicester’s Hospitals after testing positive for coronavirus.
Mr Furlong said: “Our staff are also very aware that not every family will see their loved one return home.
“Our thoughts are with all those families who have lost someone.”
TESTING TIME
Antibody tests on about 5,000 hospital staff suggest ten per cent have had the virus.
Leicester’s hospitals has given all staff the option to be tested to see if they have already had Covid19.
Health bosses said 5,000 frontline medics and others in the workforce had taken up the offer and had a blood test.
EASING BACK TO NORMAL
PPE stocks are healthy, acting chief executive Rebecca Brown told the meeting. “We have a seven-day supply of PPE and drugs. If we get down to three days, we are notified and use all of our abilities to address any issues.”
Work is under way to start up services that were put on hold during the crisis, with the aim of restoring hospitals to 75 per cent of services by the end of this month.
Ms Brown said: “We continue to work around our hospitals to create a Covid and non-Covid stream. We have a very clear structure for Covid and non-Covid, no mean feat, but we have managed to do it.
“We want to be able to get to 75 per cent of our activity by the end of June. When I say activity I mean our theatres and capacity – that won’t give us full activity because of donning and doffing, the cleaning between each patient will mean the numbers that we can get through that area will take some time.
“We have a very good, clinically
The number in intensive care or high dependency beds was fewer than 20 throughout the last month
led service that is making sure we are prioritising our patients to ensure we are bringing back the right services at the right time.
“We have now repatriated all of our services back to Leicestershire, That’s an important point for our restoration.”
READY FOR A SECOND PEAK
Ms Brown told the meeting: “We recognise there might be future peaks. We’ve got together across clinical teams so that if there are triggers, if there are areas where we foresee any growth, either in nursing homes, primary care, or within the community, we can be ready.
“We need to be able to flex backwards and forwards as and when we can.
“Clinical teams across the county – Leicestershire Partnership NHS
Trust, primary care, public health and us – have worked together to list 10 priorities. They are ambitious, but people are not prepared to go backwards.
“We recognise that we may not meet them all, but if we, alongside partners, can really push and drive this, we will have a system that offers much better care going forward in a more timely way but also closer to home. “What we’ve learned is that we need to work together for a common goal. Having a common enemy helps us focus together. We need to ensure we are clinically led, we have to be flexible, because we don’t know what’s around the corner.”
LOOKING TO THE FUTURE
Deputy medical director John Jameson told the meeting that the trust has looked at its plans for a £450 million revamp in light of what it had learned while dealing with Covid19.
He said: “We’ve noted that if we had already reconfigured we would have been able to manage this crisis better. We’ve managed things pretty well, but we would have been better placed.
“For example, we would have already had 100 ICU beds. We could expand that to other areas too, such as theatres; we would have had a standalone children’s hospital so wouldn’t have had to send children’s heart services to Birmingham and we would have had standalone treatment centre which could have been kept Covid-free where we could have redirected elective work.
“We wouldn’t have been staffing three separate rotas over three hospital sites, there would be benefits for backroom staff who could have been in a separate centre where it would be easier in terms of social distance.
“And the new-build estate is much more compliant with space between beds and infection prevention requirements.”
We have to be flexible because we don’t know what’s around the corner Rebecca Brown, of NHS Trust
AN investigation is under way after Leicester’s Hospitals had to correct a previous year’s accounts adding tens of millions of pounds to the amount by which the trust overspent.
NHS England (NHSE) said it is trying to find out whether there has been a “failure to meet formal financial governance conditions” at University Hospitals of Leicester Hospitals NHS Trust.
The trust runs the Leicester Royal Infirmary and Glenfield and General hospitals.
NHSE has commissioned its own accountants to sift through the trust’s 2018-19 accounts, which originally declared it had spent £84.1 million more than its income.
Concerns were raised when the trust carried out a “prior year adjustment in January and retrospectively added £46.2 million to the 2018-19 deficit, taking it to £130.3 million.
A spokesman for NHS England and Improvement in the Midlands said: “We commissioned PwC (PricewaterhouseCoopers) to undertake an independent review of the financial position at University Hospitals of Leicester NHS Trust. The purpose of the investigation is to determine if there is evidence of a failure to meet formal financial governance conditions. The process is ongoing.”
A trust spokeswoman said: “The trust’s financial position deteriorated due in large part to the complex impact of the balance sheet review. In view of this, the accountancy firm PwC has been engaged by NHSE to carry out an independent review to investigate the reliability of the trust’s finances and financial governance.
“We will be in a position to accurately update our forecast once the outcome of the PwC work is available. This work will also help inform the final year end accounts position and external audit.”
The Mercury has spoken to senior figures in other public authorities who said prior year adjustments on the scale made by the trust were almost unheard of.
One source said: “Something has gone catastrophically wrong here if you have to go back and accept you understated your deficit by £46 million.
“That is a staggering sum to be out by and it does not surprise me that NHS England is extremely keen to get to the bottom of how it happened.”
The trust is being run by acting chief executive Rebecca Brown, stepping in for John Adler.
The trust has confirmed Mr Adler is on sick leave and has been off since before the coronavirus pandemic began.
The Mercury understands Ms Brown sent an e-mail to the trust’s partners ahead of the publication of this story explaining it would be appearing in the media and that the trust’s long-standing deficit had been “significantly misstated”.
It is understood she said the issue was serious and she was working hard to confirm her understanding of the issue and restore the trust’s finances.