This statement is in response to the open letter received regarding Critical Care beds at Southend Hospital from Save Southend NHS.
Before responding to the individual questions raised in the letter, we want to be clear that facilities at Southend Hospital are not being downgraded; we have consistently said this to our staff, patients and communities. We are disappointed that Save Southend NHS has published this letter openly rather than engaging with us directly to seek answers to their questions when our statements on these questions have been entirely clear.
However, we cannot ignore that we are in the midst of a pandemic which, in its’ first wave, required a threefold increase in critical care capacity across all of our hospitals which was only delivered by repurposing space not normally used for this purpose and the cancellation of all routine hospital activities. This was a situation repeated across the country.
Given that COVID-19 will be a disease that will be with us for at least a year, we would not be serving our patients, communities or staff well if we continued these extraordinary measures and we therefore need to change the way we deliver services to provide care to people with COVID as well as those with other health needs. A good example of this is maintaining critical care services for major urology cancer surgery at Southend Hospital.
We are sad that this letter has undoubtedly sought to unnecessarily scare people and undermine confidence in hospital services in Southend during a national emergency.
Our responses to the questions raised within the open letter are set out below.
Please inform us how many staff will remain at Southend to run all 14 Critical Care (ITU and HDU) beds at the hospital and how many you plan to redeploy to Basildon?
We are reorganising all of our sites to ensure that COVID and non-COVID healthcare needs are addressed.
Part of this reorganisation involves catering for the sickest COVID-19 patients in one location.
This will be the MSE Specialist Critical Care Centre situated on the Basildon site.
The main reason for this decision is that there is already infrastructure (oxygen supply and appropriately configures ward space) at Basildon which will allow the patients to be cared for in one unit rather than spread across hospital sites in different locations as was the case during the first surge.
The plan involves creating a facility for 26 patients with capability to increase to 100 in the event of extreme surge.
Staffing this unit will require staff from across our three hospital sites, alongside the additional nurses and doctors we are recruiting to staff these beds. However, in the case of extreme need or an early second surge, we will need to ask our people to step forward to care for these patients again at the specialist critical care centre.
Question 2: Can you confirm that no members of Critical Care staff at Southend will be compelled to work in the new unit at Basildon if they do not agree voluntarily to the interim transfer?
The process being used to provide staff from Basildon, Southend and Broomfield Sites is a voluntary secondment process.
Questions 3 and 4:
Where do you plan to get the ambulances and suitably experienced and qualified staff needed to transfer acutely ill COVID-19 patients requiring ITU provision, across the area to the new ‘hub’ at Basildon?
How can the public have confidence that ‘treat and transfer’ for seriously-ill Covid-19 patients can be properly resourced and will be safe for patients?
We have successfully operated a treat and transfer service at weekends and bank holidays for over one and a half years. During this time patients needing interventional radiology operations, cardiology interventions and care, ear nose and throat operations as well as emergency radiotherapy procedures have benefitted from faster specialised treatment as a result of our treat and transfer service.
This service was extended during the recent COVID surge as it was necessary to scale this process up to transfer COVID patients between our sites. We successfully ran this process for three weeks using skilled doctors from our hospitals and Essex and Herts Air Ambulance to transfer a number of patients on ventilators between our hospitals when we did not have sufficient capacity. This was complemented by a regional patient transfer service that was established to move critically ill patients throughout the region. It is recognised that moving patients to Critical Care Units which had capacity, rather than creating capacity in operating theatres and associated spaces, was the correct thing to do for patient care and to provide a safe working environment for clinicians.
We have worked with East of England Ambulance Service and St John Ambulance to commission the ambulance vehicles and staff to provide this inter-hospital transfer service seven days a week so that we can continue to safely move patients between our critical care units if required.
Our treat and transfer services is operated according to a strict protocol and the process which has been reviewed by the East of England Clinical Senate, North East London Trauma Network, East of England Trauma Network, Association of Anaesthetists of Great Britain and Ireland, local and regional Intensive Care and Emergency Care physicians amongst others.
Question 6: Can you promise the public that your proposals for the removal of staff from Critical Care at Southend are for the current pandemic only and that they will not involve any reduction or ‘downgrading’ of the current range of services at Southend Hospital?
As described above, we are absolutely not downgrading Southend ITU or HDU. None of the 14 critical care beds at Southend will be lost as a result of this change, although the numbers available may decrease by one or two beds temporarily if there is a COVID-19 surge, with staffing at the Specialist Critical Care Centre prioritised. There will also be no loss of 24/7 A&E services at any of our sites which I know has been raised by Save Southend NHS in other communications.
Our plans for the future of hospital services are clear and have been consulted upon, with more information being available at www.msehealthandcarepartnership.co.uk