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Empty expanse of Nightingale Hospital Birmingham is tribute to the work of the NHS

Birmingham's Nightingale Hospital has yet to see any patients – and it is hoped it may never be used at all.

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Ready for action but not yet being used – the Nightingale Hospital at Birmingham’s NEC could cater for 4,000 patients

The hospital at the NEC was built in less that a fortnight. But since being officially opened by Prince William, it has yet to be put to use.

It has a potential capacity to take up to 4,000 patients and is served by a giant mortuary at Birmingham Airport.

When the Birmingham Nightingale Hospital was announced at the end of last month, it carried with it fears of a doomsday scenario.

The temporary site features 70,000 sq metres of clinical floor space.

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It was created to provide extra capacity to ease pressure on local services dealing with the increased number of patients during the peak of the pandemic.

And while its construction was undoubtedly a phenomenal effort by all concerned, its very existence to serve an area stretching into Shropshire, Staffordshire and even Derbyshire highlighted the scale of the problems faced by the region at the time in its battle against Covid-19.

Hospital deaths in the West Midlands – particularly in Birmingham and parts of the Black Country – were far higher than everywhere in the country with the exception of London and the south east.

By the end of March the region accounted for one in five of all coronavirus related deaths in the UK, with the Royal Wolverhampton NHS Trust at one point recording the second highest death toll from the virus for any trust in the country.

Part of the NEC has been turned in the new temporary NHS Nightingale Birmingham Hospital

The death toll was rising so steeply that the day the hospital opened, April 3, had been expected to coincide with the majority of the region’s hospitals reaching full capacity. Concerns grew further when days later a temporary mortuary opened next door in a hangar at Birmingham Airport, with space for up to 12,000 bodies.

But over the past three weeks things have changed.

While the West Midlands remains a virus hotspot – for reasons the Government is still not entirely clear about – it now seems our worst fears may not come to fruition.

Over the past 10 days the death rates in our hospitals have generally declined, albeit with daily fluctuations, suggesting a levelling off is taking place.

As is the case with the rest of the country, hospital admissions also appear to have plateaued.

The Duke of Cambridge speaks via videolink as he officially opened the NHS Nightingale Hospital Birmingham

Barring an unexpected second wave of the virus, health experts believe we may now see a continual decline in hospital admissions.

Should such a scenario play out, it would mean that both the field hospital and the mortuary will have been built at great expense for little or no use.

The irony, of course, is that this is precisely the outcome that leaders across the region want to see.

West Midlands Police Chief Constable Dave Thompson summed up the mood perfectly in a strategic board meeting on coronavirus planning last week.

Speaking about the mortuary, he said stakeholders across the region had been determined “not to get it wrong”.

It took a huge effort by staff to establish the hospital inside halls at the NEC

There had been a fantastic collective effort from the airport, NHS trusts, local councils, the coroner’s office and local businesses, he said, to create a facility that was “at least as good” as what people would expect to find in a standard hospital.

“I think everybody hopes it is the single largest waste of money that we’ve all been involved in, because we don’t want to use the facility,” he added.

All things considered, the region’s hospitals have stood up remarkably well to the complex threats posed by the disease.

There have been issues – most notably a lack of PPE – and local firms had to step in to sort out some ventilators that arrived from China with plugs that did not fit.

But none of the hospitals have yet reached capacity, and there has not been a single report of patients being turned away.

The Army played a huge part in getting the hospital ready

It is something that is not lost on West Midlands Mayor Andy Street, who says people’s efforts to adhere to social distancing measures have reaped dividends.

He said: “Turning the NEC into a Nightingale hospital in under two weeks was an absolutely Herculean effort.

“Everyone involved from the military, to the NHS, and all of Interserve’s staff deserve the most enormous credit for working round the clock to make it happen.

“The hospital opened at the exact the time the original data showed us it would be needed, as our existing hospitals across the West Midlands would hit full capacity.

“As it happens, because people across the region have been so responsible during lockdown and our hospital trusts have brilliantly managed the demand, there is currently no need for the Nightingale and no patients have yet been admitted.

“And, despite all the hard work and effort that went into getting it up and running, I actually hope it stays that way. The fact it has not needed to be used, despite previous projections, underlines just how well the region’s hospitals have managed the crisis despite the high number of deaths and infections.”

A worker pictured at the new temporary NHS Nightingale Hospital which was created in a fortnight

Mr Street said that talks were now underway about how else the Nightingale could be used, with health bosses suggesting it could be opened up for non-virus related treatments, including operations.

The experience of the Birmingham Nightingale is being replayed across the country, where a number of other temporary sites are either up and running or about to be opened. London’s Nightingale, at the ExCeL exhibition centre, was first to open on April 7.

Sitting in the heart of the nation’s coronavirus pandemic, it was expected to by far the busiest of the lot, with NHS England saying they feared hospitals in the capital would be overwhelmed by the numbers of people needing intensive care.

At the time, Health Secretary Matt Hancock said the NHS was “preparing for the worst but hoping for the best”.

An ambulance outside the hospital at the NEC

Yet by April 20 it had only treated 41 patients, although around 50 people were turned away due to staffing shortages and medical decisions. Some have taken the hospital’s lack of use as evidence that it is little more than a white elephant, with existing hospitals successful efforts to increase capacity meaning it was not needed.

But NHS planners see it differently, with senior executives taking the view that it was better to over-prepare for the pandemic.

A senior intensive care doctor said: “It was a sensible project designed to stave off the type of situation we saw in Italy.

“It may have just been a matter of days and we would have been thankful it existed. Thankfully, good surge planning to massively increase critical care capacity in hospitals, and a last ditch redistribution effort to move patients from stressed small hospitals to larger hospitals with space, has meant that we have not needed this type of facility.”

NHS leaders in the capital also believe the Nightingale hospitals will be vital in helping primary hospitals restore services, such as elective surgery, and cope with rising Covid-19 demand as social distancing measures are relaxed. While this crisis continues, they provide a very welcome safety buffer for the NHS.