Imperial Healthcare Trust has written to HAFSON to explain urgent changes to neurosurgery services at Charing Cross as a result of pressures from corona virus. HAFSON understands the need for these temporary changes given the pressures under which Imperial Hospitals, like other hospitals, are now working. Here is the text of the letter:


I wanted you to have this update on the expansion of our critical care capacity and urgent changes to neurosurgery services at Charing Cross Hospital.

As part of the NHS’ co-ordinated response, the capacity expansion for critical care in north west London is focusing primarily on Imperial College Healthcare, Chelsea and Westminster Hospital NHS Foundation Trust and the Royal Brompton & Harefield NHS Foundation Trust. This is to enable care for the more complex patients in our sector to be consolidated into the hospitals with the largest existing critical care resource.

Imperial College Healthcare has already extended beyond our normal critical care/ventilator capacity of 68 beds, towards our first phase of expansion to 143 beds. To ensure all patients who may need critical care in London over the coming weeks get that care, we plan to increase our capacity rapidly by up to another 157 beds across our three main sites at Charing Cross, Hammersmith and St Mary’s hospitals.

We also need to continue to provide, equally essential, ward-based general and acute care and we are working with other providers and community colleagues to create care pathways that reduce demand on our inpatient services where possible.

We are moving to new staffing ratios set by NHS England to support this expansion in care – our specialist critical care staff need to be supported by clinicians from other disciplines as well as health support workers. We are also working hard to recruit additional qualified staff, health support workers and volunteers. A relatively small number of our staff have been asked to work at the new Nightingale Hospital at the ExCel Centre in east London but we do not expect more staff to be seconded if we are able to step up our own capacity as planned.

These essential changes to the way we work now need to include an urgent change to our neurosurgery services as we are not currently able to run two full neurosurgery medical rotas safely at both St Mary’s and Charing Cross. This is due to redeployment of many doctors to support the expansion in critical care across our sites as well as high levels of staff absence due to sickness and mandatory self-isolation. It also frees up suitable space to be turned into critical care/ventilator units temporarily.

For the period covering our response to the coronavirus emergency, we are consolidating our acute neurosurgery service at St Mary’s where our major trauma centre creates the largest demand, with a small amount of critical cover at Charing Cross for the small number of acute neurovascular cases linked to the hyper acute stroke unit. We expect this change will mean providing emergency neurosurgery at St Mary’s for up to 10 patients per week who would previously have had their surgery at Charing Cross. The change does not impact on our stroke services, which will remain at Charing Cross including thrombectomy.

We have written today to Hammersmith & Fulham Council to say that in the current emergency situation the temporary change to neurosurgery is so urgent that it is not practical to go through the normal process of engagement and agreement with them and involvement of patients, user groups and the local community. The aim is to restore the normal service as soon as the current crisis abates.

I hope this information is helpful.