How Watford General Hospital has been transformed to cope with the coronavirus crisis

The hospital is facing pressure it has never seen before, as the number of confirmed cases of Covid-19 in Hertfordshire passes 1,300.

Now the chief medical officer at the hospital has given readers an insight into how he and his colleagues are coping with the pandemic.

Watford General Hospital hit the national headlines last weekend after it had to declare a critical incident, with its oxygen system set to hit maximum capacity.

Read more: Oxygen system at Watford General hit maximum capacity 

Though the hospital did not run out of oxygen, it was a clear sign of the pressures facing the site and its precious equipment.

The hospital had to shut its doors to new patients, including A&E, and West Hertfordshire Hospitals NHS Trust has warned the trust may have to take similar action if the systems max out again.

The changes to the hospital and its operations

Much of the hospital is now set up to treat Covid-19 patients.

The hospital is now in what it describes as ‘phase four of five’ and says around 200 beds are currently being used by patients with confirmed or suspected coronavirus.

Chief Medical Officer Dr Mike van Der Watt says the hospital can stretch to 300 beds if necessary, having scaled back all other activity.

Theatres and recovery wards have been turned into places where critically ill patients can be treated.

Dr Mike van der Watt

Dr van Der Watt said the hospital began preparing for the coronavirus outbreak in earnest when the number of UK deaths was still in single figures.

Dr van Der Watt said: “We worked out what capacity we were going to need and created a phased approach, taking into account the different types of breathing support we would need to provide.”

Alongside the creation of coronavirus wards and isolation units, the pandemic has led to further changes to the hospital.

All visitors are being kept away - all non-urgent appointments have been cancelled, and patients who need urgent or cancer treatment are being seen at the private Spire Hospital in Bushey.

Meanwhile the minor injuries unit at St Albans City Hospital has shut to enable staff to move over to Watford.

Most outpatient appointments are now taking place via phone or video call.

But for those still at the hospital, physical changes include additional air lock doors leading to isolation areas, as well as the creation of temporary decontamination facilities and increased mortuary capacity.

As more and more patients are admitted to the hospital, resources have been strained and hospital staff have switched roles to help where they can.

For example, surgeons are working on medical wards, the trust has therapy staff providing patient care, and play workers are staffing the newly established phone line for relatives.

More than 200 calls are being made a day to relatives who are unable to be by their loved one’s side due to visiting restrictions.

Around 500 additional training sessions have been arranged to ensure that clinical staff can use breathing equipment and understand how to care for rapidly deteriorating patients.

Although hospital staff remain professional in the work they do, the increased rate in deaths inevitably has an effect on their own wellbeing.

With many patients dying alone, the trust says it is providing a range of support for its staff including counselling and special areas where they can take a break.

The hospital’s charity, Raise, is working around the clock to support its staff by visiting the West Herts Covid Just Giving page, which has raised more than £40,000 so far.

Dr van Der Watt said: “Everyone has certainly risen to the challenge and the team work has been really good.

“Obviously, there is some anxiety as Covid-19 is still an unknown disease so I couldn’t say that staff particularly look forward to working in those areas, but they are doing it with really good cheer.

“And the amount of positive feedback we’re getting from patients about their care has been really heartening.”