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Vaughan Gething, Minister for Health and Social Services

First published:
22 March 2021
Last updated:

Field hospitals have been an important part of the overall strategy in meeting the challenge of the pandemic. They were initially planned and developed against a backdrop of significant additional predicted demand and the risk of the NHS becoming overwhelmed.

Field hospitals in Wales have been open and utilised consistently since October 2020. Ysbyty’r Seren in Cwm Taf Morgannwg University has been one of the busiest, if not the busiest field hospital in the UK with over 200 admissions to date. During the past 12 months, they have provided important additional capacity in a number of areas of Wales during peaks in pressure on our acute hospitals. To date, over 930 patients have been admitted to a field hospital in Wales. These patients no longer required medical intervention in one of our acute hospitals but still required additional support or were waiting for a care package before being discharged.

The additional staff and bed capacity provided through these sites has been instrumental in enabling people who are recovering, and well enough, to leave acute hospitals, freeing up much needed capacity in acute and community hospital sites. Health boards estimate they have helped save over 14,500 ‘bed days’ for acute sites.

The predominant model in use across Wales has been a ‘step-down’, medically optimised model, focussing on multi-professional and integrated teams facilitating the handover of care back to the community. They have enabled provision of additional and often much needed rehabilitation to patients.

Additional staff training has been instrumental in enabling field hospitals to function well, and empowered excellent working relationships across local teams to develop, including the integration of therapy staff into the clinical teams. Some health boards redeployed nurses with a mental health background to the sites, and reported this had worked very well especially in supporting patients who had cognitive impairment. This is an example of good practice that we are keen to explore and possibly apply to other areas of acute health care across Wales. A strong team ethos has allowed staff in field hospital environments to deliver an excellent standard of care, and something we are keen to learn from in the future.

It is a testament to the NHS field hospital staff that the majority of patients have received positive outcomes and reported positive patient experiences, saying they felt safe and involved when decisions were made about their care and treatment. Health boards have used innovative ways to measure and collect patient feedback and outcome data, for example one health board reported “100% of patients felt safe whilst in their care”. Furthermore, a number of innovative approaches have been described by health boards to support the emotional and psychological needs of patients in field hospitals. Virtual visiting and the use of a Family Liaison Officer are just some examples that have been adopted to support communication with patients and their relatives.

Robust admission criteria, safety and governance processes have been implemented across the health boards, meaning there has been a low number of complaints and incidents reported, with low transfer rates back to the acute hospitals. In November 2020 Healthcare Inspectorate Wales (HIW) conducted a routine inspection and visited two field hospitals in Hywel Dda UHB and concluded that the hospitals had effective systems in place to maintain patient safety and dignity. In February, HIW conducted an extended quality check at Ysbyty Enfys Deeside in Betsi Cadwaladr UHB following changes to their patient criteria. HIW concluded a number of areas of positive findings such as caring and compassionate staff, and identified some areas for improvements. We are committed to ensuring lessons from the field hospital experience are learned across the health and social care system.

Throughout the pandemic our intention in regard to field hospitals has been clear: to ensure that we have sufficient capacity in the system whilst delivering the highest possible quality care for everybody who needed it in extremely challenging circumstances. Establishing field hospitals was intended to ensure essential acute hospital NHS capacity was protected in order to deal with a potential worst-case scenario and save lives.

In September 2020, I updated Members on Health Board plans to retain over 5000 additional beds for the rest of 2020/2021 which incorporated retention of eleven field hospitals. Five of these field hospitals have since opened for patients whilst the other six have been actively utilised to support the Covid-19 response in other ways. They have provided essential additional space as vaccination centres, testing hubs and training facilities.

Increasing Covid-19 related sickness absence rates during December to February, and staff redeployment across the system made it a challenge for health boards to provide sufficient staff to increase capacity in field hospitals to a substantial level. However, at the peak of the pandemic, some field hospitals were operating with a capacity of around 70 beds. Encouragingly, the reduction in system pressures across acute hospitals, coupled with the redeployment of staff back into their substantive NHS roles as other services resume, has lessened the requirement for field hospital capacity over recent weeks.

However, given the prospect of further ‘waves’ of Covid-19 and uncertainty around the surge capacity required by the NHS to manage any resultant increases in demand, we have asked health boards to consider whether field hospital facilities should be maintained in 2021/2022. In developing local plans, health boards will also consider whether existing field hospital facilities could add value – where it is prudent to do so - through delivery of other services based on local population need.

We will continue to monitor the situation and work closely with health boards as part of this planning process.