We were interested to read the article ‘The COVID-19 emergency hospitals: seizing the challenge’ in the May 2020 issue of The Pharmaceutical Journal, and here we report how working together across the hospitals in our area allowed the NHS Nightingale Hospital Yorkshire and the Humber (NYH), set up in Harrogate, to be established so quickly.
Through a memorandum of understanding between NYH and Leeds Teaching Hospitals NHS Trust (LTHT), we could quickly establish efficient and effective procurement, bulk preparation of a range of standardised parenteral products, packing of stock medicines for halls (wards) in the pharmacy warehouse at LTHT, and standardised clinical protocols.
The NYH was headed by leaders from across the Yorkshire and the Humber hospitals, comprising staff shielding at home and linking in with Microsoft Teams; staff based fully at NYH (retired and returned senior pharmacists); and also staff fulfilling dual roles (both in their base Trusts and at NYH).
The project was split into a set of small working groups which covered procurement, medicines supply, governance, clinical service, staffing and training. The chief pharmacists across West Yorkshire were each linked to a working group and pharmacy colleagues from many Trusts across Yorkshire and the Humber joined in the project work.
We sought to ensure the staff levels at local Trusts were not depleted, and balanced these with the needs of the Nightingale; and the pharmacy staff-to-patient ratios were based on those used by Nightingale hospitals in London and Birmingham. Our workforce was made of volunteers across local Trusts’ pharmacy departments. Our local pharmacy professional network was essential to identifying staff and organising their induction, all within a very tight deadline of five days.
The NHS project work at NYH was supported by the Army, who used their ‘testing of battle preparedness’ tools to help the NHS to assess the processes and services designed. We became practised in the art of the ’rehearsal of concept’ tool, something which the NHS could use to great effect in service redesign.
The project work was also supported by KPMG, whose project management skills created pace: we benefited from twice-daily briefing huddles involving all workstream leads at NYH, document management systems and organisational support.
Collaboration both within the pharmacy team and across all the work streams was excellent; we quickly developed a valuable network, which helped us to make rapid process and allowed us to be flexible to change. Our pharmacy team held daily huddles to identify tasks and gaps, and we used rapid decision-making and problem-solving skills associated with lean re-engineering. Our structure was open and non-hierarchical, and we had a positive ‘can-do’ culture. Some of these techniques will be valuable to us in our routine work. And we also identified the focus and efficiency benefits of taking staff from their organisations to take part in this kind of transformational project in future.
Our memorable experience was well summarised by one colleague: “It was the most rewarding and exhilarating experience of my career to date, but because of the time commitment and stresses involved it was one of the most emotionally challenging projects I have ever worked on. That said, I would love to do it again.”
Liz Kay, Elaine Weston, Sophie Blow, Stuart Parkes, Kate Nixon, Kirsty Cavill, Emily Wardle, Andrew Alldred, all at the NHS Nightingale Hospital Yorkshire and the Humber