Service reconfiguration to provide resilience for Covid-19 pandemic

In preparation for an expected increase in Covid-19 related inpatients, the Lancashire Teaching Hospitals NHS Foundation Trust will temporarily reconfigure its services to maintain safe and effective patient care.

The reconfiguration of our sites follows the clear advice from senior clinical leaders from within Lancashire Teaching Hospitals and the wider Central Lancashire health community. The moves which are essential to save lives have the full support of the Trust’s Board of Directors, the Clinical Commissioning Groups, the Lancashire and South Cumbria Integrated Care System as well as NHS England and Improvement.

This reconfiguration is vital to safely support a 400% increase in the number of critical care beds with available staff in the coming weeks. The main benefits include the following:

  • a single point of access to emergency care for Covid-19 positive patients
  • the ability to safely separate patients who do not have Covid-19 and those who are suspected as having Covid-19
  • delivery of a 24/7 consultant on site presence for the Emergency Department and extended presence for critical care and respiratory consultants,
  • senior clinicians will deliver a seven day specialist review of highest acuity patients
  • a larger pool of clinicians will be available to work in the emergency department

The decision of our senior clinical leaders has been made to move all acute respiratory medicine  from Chorley & South Ribble District General Hospital (CDH) to Royal Preston Hospital (RPH). All GP admissions and ambulance calls with respiratory complaints will be directed to Royal Preston Hospital.

The Trust will expand its emergency department footprint at RPH, moving into the current day case theatre, day case ward and medical escalation ward. This will provide adult, paediatric, and resuscitation space for confirmed and suspected Covid-19 patients which will be separate from the normal department.

From Wednesday 1st April, the emergency department and critical care provision at CDH will be reconfigured into a 24 hour Urgent Care Centre (UCC). This will be supported by ambulatory care, the elderly care team, GPs and specialist surgical teams, the UCC will continue to treat a range of conditions and ambulance cases, such as chest pain, frailty and other non-respiratory medical cases. Having available beds at Chorley will enable the admission of patients that would normally go to Preston; building on local expertise in rehabilitation and frailty this is planned to be a cohort of longer- term, frail patients.

Consultants who support the critical care unit and A&E department at CDH will move to RPH to allow the support of round the clock consultant rotas. This means that our most experienced consultants will be on hand 24/7 to care for our sickest patients.

A provisional date for the services to return to their former function has not yet been set, however, a thorough de-escalation plan will be prepared.

Clinical leaders from across Central Lancashire have developed these plans and together we have a responsibility to act in the best interests of patients and staff. We call upon our communities to support the decision at this unprecedented time.