Hospital works to reopen more services as Covid-19 cases reduce

The UK’s leading heart and lung hospital is working to reopen more of its non-emergency services as the number of Covid-19 patients gradually reduces, allowing redeployed staff to return from the critical care unit to their usual departments.

Royal Papworth Hospital in Cambridge has continued with emergency surgery throughout the pandemic, including heart and lung transplants, but around 140 registered nurses were redeployed to either critical care or respiratory wards to help treat coronavirus patients.

Some services had to be reduced as a result, including planned elective heart surgery, and staff are now working to increase capacity.

The PA news agency was granted rare behind-the-scenes access to the hospital as the anniversary of the first national lockdown, on March 23, draws near.

David Jenkins, consultant cardiothoracic surgeon at Royal Papworth Hospital in Cambridge, said that coronavirus patients still occupy around half of the beds in the hospital’s intensive care unit.

In the most recently available figures, there were 38 patients in critical care – and 18 of them were Covid positive.

Many services continued throughout the pandemic, including lung cancer and emergency cardiac surgery, but planned elective cardiac surgery patients “lost out and had to wait longer”, he said.

Mr Jenkins, 56, said: “We’re trying as much as possible to restart our usual services but we’re probably only on less than half capacity of our normal elective cardiac surgery as we still have a lot of Covid patients in intensive care and staff are redeployed in intensive care.

“We could do more cardiac surgery if we had more staff and that’s our limitation at the moment.”

He said that after the first wave services “recovered really quickly”.

“There’s always a bit of a worry for heart and lung patients that actually during the waves of Covid they haven’t gone to see doctors and they haven’t presented so we do worry there may be some unmet needs out there and our waiting lists are still quite high at the moment because we’ve been doing less surgery,” he said.

“I hope we rapidly recover over the next few months but it may take a year or so to get back to the steady state so it’s certainly not over.”

Stephen Webb, consultant in intensive care, said the intensive care unit almost doubled in capacity from around 33 beds to 65 beds at the height of the first wave.

“We had to stretch our resources much more thinly,” said Dr Webb, 45.

“We had to open up other areas within the hospital that used to be outpatient clinics, that used to be day wards, to become critical care units.”

He said that some services were “completely shut down” in the first wave but reopened afterwards and continued in the second wave.

“We’re very conscious that Royal Papworth doesn’t just deal with Covid patients but we’ve got a commitment and a belief that we need to treat patients with all forms of heart and lung disease,” he said.

Consultant cardiologist Patrick Calvert said that in wave one there was a drop in patients presenting with heart attacks.

“We subsequently discovered of course that people were still having heart attacks, they simply weren’t presenting at hospital and having them treated,” said Mr Calvert, 45.

“This is obviously a dangerous situation.”

He said that the number of heart attack patients increased during the second wave, adding: “The hospital has had to ramp up its ability to treat those – we’ve been running at about 35% over normal activity for the past number of months.”

He went on: “We’ve lost a great deal of our staff to the intensive care unit of course to treat people who have Covid there which means it’s been difficult to maintain ordinary services.

“We’ve kept services running for heart attacks and I emphasise it’s important that people do present with those symptoms.

“And right now since we’re coming over the end of the second lockdown we’re trying to catch up with those patients with stable symptoms and not only disease of the coronary arteries but also structural heart disease.

“Staff are working very hard to treat those patients who’ve been waiting for their treatment.”

Dr Robert Rintoul, lead clinician for cancer, said that lung cancer referrals to Royal Papworth from other hospitals fell by up to 80% at the start of the first wave.

He said they rose to around 75% of normal referrals by late 2020 and continued through the second wave.

The consultant respiratory physician, 54, said: “I think as the number of Covid cases go down, as the vaccination programme goes up this gives people a lot more confidence to come out to seek help.”

He said the NHS is a “very safe place to be” and “we absolutely want people to come forward if they have symptoms”.