Covid wards

Harrogate District Hospital has about 320 beds in total, and about 85 per cent are currently occupied.

There are two red wards — designated wards for confirmed or suspected coronavirus. The wards have about 60 staff. When one ward has more than 15 patients the second one is used. "We chose wards with the highest number of side rooms," said Mr Russell.

He added that as part of the hospital's surge plans, it would reduce other activities if the number of covid patients grew significantly and staff had to be redeployed. He said staff with the closest skill set for critical care, such as theatre staff, would be the first to be moved.

Mr Russell said the point at which this happened would be determined by a range of factors, including the overall pressure on critical care rather than a set number of covid patients and so far during the second wave the hospital had not reached it.

It currently has about 15 covid patients compared with 50 to 60 at the peak of the first wave. He said:

"The most important thing is how we are coping overall. And at the moment we are coping well."

Critical care

The hospital's base critical care capacity is seven. This can 'flex' to 10 and has the capacity for another six to eight patients.

Although there were far more covid patients at the peak of the first wave than there are currently, there were more beds available in spring because the hospital had cancelled most other activities. Mr Russell said:

"We didn't know as much about the disease during the first wave. We now have new drugs, we manage patients better, we have non-invasive ventilators that allow patients to stay awake as well as mechanical ventilators. We have enough ventilators to cope."

The hospital hasn't redeployed any staff to treat covid patients during the second wave. Mr Russell said it ran training sessions to prepare staff for this during the first wave and it planned to run refresher sessions.

'Right to lockdown'

Mr Russell described the decision as 'a logical and understandable step', adding:

"If we look at what's happening across the NHS more broadly and the growth of pressure other hospitals are experiencing, I think it was a wise decision. The measures that we had in place didn't seem to be slowing the pressure on hospitals as much as needed."

Staff under pressure

The trust employs about 4,500 staff, of which about half are based in the hospital. Mr Russell said it had been one hell of a difficult year but he had never been prouder of being part of the NHS. He said:

"There is quite understandably a sense of anxiety. People are tired; they are anxious about what might come because winter is generally a busier time for the NHS. It doesn't matter how well you prepare you can't predict the future."

He said the trust had put in place health and wellbeing support for staff. Currently absenteeism was only about 1.5 percentage points higher than usual, and six staff were off yesterday due to test and trace. Staff are only tested for covid when they display symptoms. Mr Russell said:

"Healthcare professionals are sociable animals. Lunchtime has always been a sociable affair. But staff now have to sit further apart, wearing face masks and goggles. It is'n't nice. It's uncomfortable. But they know it's necessary."

Visiting restrictions

The hospital is ending routine visits today. The only exceptions will be around vulnerable groups.  Mr Russell said this had been a difficult decision that had been debated this week, and the biggest dilemma was about allowing visits to terminally ill patients. He said:

"People find it distressing not being able to visit people at the end of life and so they will be one of the exceptions."

Nightingale staff

Mr Russell is also chief executive of the Harrogate Nightingale hospital, which he describes as "an insurance policy we hope we never need".

But if it is, Harrogate District Hospital may have to redeploy staff. Mr Russell said it had identified 10 or 11 staff of 12 or 13 that could be redeployed. Other hospitals in the region would have to do the same. He said this was part of the hospital's escalation measures and could result in it having to pause routine work.

'Difficult to switch off'

Many of us think we have stressful jobs but being in charge of a hospital during a pandemic is something else. "Switching off has been difficult," Mr Russell admits. He had booked a family holiday to Africa next week. This changed to a trip to the New Forest when overseas travel became difficult. Now, with lockdown, he will be staying at home in Harrogate. He said:

"I get a lot of resilience from friends and family, and I'm lucky to have such a fabulous team around me."