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Flexible healthcare’s essential role in safely restarting surgery

Flexible healthcare infrastructure - such as mobile operating theatres, endoscopy procedure units and wards - can provide an answer to the key challenge hospitals face in safely restarting elective surgery. David Cole, CEO of Vanguard Healthcare Solutions, explains how.

As the number of COVID-19 cases fall, hospitals have begun preparing to restart planned care, such as elective surgery, endoscopy, diagnostic tests, and scans. However, things remain a long way from ‘business as usual’. Whilst the most immediate crisis may be over, some hospitals continue to care for a large number of COVID-19 patients, and there is also a real prospect of a second wave or further localised outbreaks.

At the same time, waiting lists are growing. Some reports suggest that waiting lists for elective procedures could top 10 million by the end of this year if urgent action isn’t taken to address the issue, and hospitals are now under increasing pressure to implement solutions for safely reintroducing these procedures, as soon as possible.

Waiting lists are likely to continue to build even when planned surgery is reintroduced, as hospitals face several challenges in restarting procedures safely and, as a result, will initially see significantly reduced productivity levels. The need for staff to wear additional PPE, increased downtime of facilities in between procedures and the introduction of screening and social distancing measures for patients all contribute towards lower productivity.

As a result, the most urgent cases will be prioritised, which may cause waiting lists for essential but less urgent surgery, such as hip or knee replacement and cataract surgery, to inflate. The very term ‘elective procedures’ is increasingly misleading, as it implies that patients have a choice of whether to go ahead with an operation. The reality is that many of those patients will be experiencing increasingly chronic pain and impairment to their lives, and the majority will not consider their procedure a choice, but an increasing necessity.

The key challenge for hospitals in restarting surgery is how to keep both patients and staff safe from the risks associated with exposure to COVID-19, in particular given the fact that many of the patients requiring surgery or treatment will be more vulnerable to illness because of other health conditions, and managing the pressure on physical space can be difficult.

Healthcare providers are now being asked to create ‘clean’ zones for restarting elective surgery, away from any COVID-19 areas within the hospital and with separate patient and staff journeys. NHS Trusts are dealing with this additional challenge in different ways. Some are reconfiguring their entire estate and moving all elective surgery to a particular hospital within the trust which has been designated a ‘clean’ or ‘cold’ site. But for many Trusts, this approach will not be practical and estate limitations mean that both COVID-19 and COVID-clean areas will need to co-exist at the same site.

Many hospitals will have sufficient clinicians and staff to return to pre-COVID levels of activity, but with the reduced productivity will be unable to do so without additional physical capacity. Where will this additional capacity come from, and how will the patient journey for elective surgery impact on existing staff and patient flows?

One of the easiest and most effective ways to introduce a clean zone for essential surgery is to use an external building or unit. Flexible healthcare options, such as temporary mobile or modular units, can provide the ideal ‘COVID-clean’ environment for safely restarting procedures.

Vanguard’s facilities provide the ideal, customisable solution, for example a mobile and modular combination can be configured to provide an operating theatre, ward, separate reception area, staff rest areas and changing rooms to form a stand-alone complex. If required, temporary units can also be supplied fully equipped and with experienced clinical staff, eliminating the need for staff rotation between the ‘clean’ site and other parts of the hospital. 

An example of Vanguard's operating theatre.

The use of flexible healthcare infrastructure options could be essential to safely achieving an increase in capacity and make a real difference to waiting lists. Mobile operating theatres and wards can be deployed very rapidly to provide a complete, stand-alone ‘clean’ site for treating patients safely away from COVID-19 areas, but can also be connected to a hospital’s existing clean or ‘green’ zone to provide additional theatre capacity. A number of hospitals across the country are already using Vanguard’s mobile facilities in this way.

Since the pandemic and the resulting backlogs have brought a need for temporary additional capacity, it makes sense to consider flexible healthcare options that allow hospitals to upscale based on their needs. Mobile and modular facilities can be used either on a temporary or semi-permanent basis, as required, and can be moved elsewhere once the immediate need has been fulfilled.

Vanguard Healthcare Solutions has been a trusted partner to the NHS for over 20 years. Its mobile fleet incorporates the most up-to date solutions from its medical equipment and technology partners.

To find out more, please visit www.vanguardhealthcare.co.uk or send us an email.

David Cole, CEO of Vanguard Healthcare Solutions